DelVax Enrollment

To enroll with DelVAX you must request a Facility ID Number from DelVAX. Use the following steps to do this.

1. Go to http://www.dhss.delaware.gov/dhss/dph/dpc/immunize-providers.html.
    

2. Click DelVAX Facility Code Request Form.
    

3. Fill out the form online, entering the Electronic Health Record (EHR) Company Name as STI Computer Services, Inc., and the IT Contact Name/Phone as Carl Payne / 610-650-9700.
   
   NOTE: You can also print the blank form and fill out by hand.
    

4. When finished, print and fax the form to: Cheryl Oliver-Knight, DelVAX Immunization Program at 302-739-6627.
   
   NOTE: You can also save the file for future reference.
    

5. Cheryl will then contact you to complete enrollment process and assign a Facility ID Number. Once you receive your Facility ID Number, please contact STI Computer Services. You will receive one Facility ID Number for each location, if you have multiple locations.