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Opt-out Forms (temporary, not recommended)


Kindly note: Opt-out is not recommended and cannot be done on a plan-by-plan or employer-by-employer basis. For a given payer, 100% of all clients must authorize opt out for the payer before the payer may make an opt-out election. Even then, the opt-out is not permanent.

Assessable Entities 2016 Opt-Out Procedures

2017 AVAP Opt-Out Form

2016 AVAP Opt-Out Form

2016 AVAP Client Authorization for Payer Opt-Out







AVAP Tax ID: 92-6001185


Copyright 2014 Alaska Vaccine Assessment Program