Provider Profile Enrollment/Re-enrollment
How Do I Enroll/Re-enroll in CVP?
Re-enrollment for existing providers is annually October through December. New providers can join the program at any time. All enrollments/re-enrollments are done electronically directly in CT WiZ.
All public and private health care providers who receive vaccine from the Connecticut Vaccine Program (CVP) must re-enroll electronically in CT WiZ. This enrollment provides shipping information and helps to determine the amount of vaccine to be supplied. The enrollment is also used to compare estimated vaccine needs with actual vaccine supply. The Connecticut Vaccine Program will keep this record in CT WiZ with the SIGNED “Provider Agreement". The Provider Profile must be updated annually or if there are changes to your patient enrollment and insurance status. Any updates to clinic information such as: address, delivery hours, or staff can be made directly in CT WiZ. Complete one Provider Profile for each office/site/satellite office.
A few things before you proceed:
- Print and review Provider Profile Checklist
- Review the Provider Agreement (do not email)
- Review the Provider Profile Training Guide
- View the Provider Profile Enrollment/Re-enrollment video (19 minutes)
- View the Physician Signing the Agreement/Medical Equivalent video (6 minutes)
- Request access to CT WiZ, if you don’t have access already.
Complete Re-enrollment |
To re-enroll, log into CT WiZ. In the left menu, click on “Clinic Tools” and then "Enrollments" to complete the process.
Please remember that the Physician Signing the Agreement (or equivalent) must log into CT WiZ to electronically sign the agreement. The primary coordinator cannot sign the agreement for the physician. Need help completing the enrollment? Review these "Tips" to help you complete it faster. |
New Provider Enrollment |
If you are a new provider joining the CVP Program, please fill out the New Provider Enrollment Form and e-mail to dph.immunizations@ct.gov. Once we receive this form, a member of our staff will review the information and contact you. In order to be an approved CVP provider, you must receive a new enrollment visit by a DPH staff member. This visit will review the following:
Once approved, clinics can request access to CT WiZ and complete the enrollment process. A DPH staff member will contact you for CT WiZ training. |
Supporting Documentation |
You will receive a site visit every other year. For the years you do not receive a site visit, you need to complete the following "You Call the Shot" modules: Vaccines for Children (VFC) and Storage and Handling. |
Re-enrollment Status/Help |
The re-enrollment is only open until the specified closed date in December. If the re-enrollment is not completed by this date, your clinic will be suspended from the program. When a clinic is suspended from the CVP, they are no longer able to receive vaccines until all outstanding issues are resolved. If you have any questions about re-enrolling, and have reviewed all documents on this page, please submit a helpdesk ticket. A member of the DPH staff will contact you in a timely manner. |
Clinic Changes |
If your clinic has changes throughout the year such as address or staff changes, you can make the updates directly in CT WiZ. Login with your CT WiZ username and password. Review the training material to find out how to process the change.
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