Vaccine screening consent form 2025

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By law, the following information must be documented on the patients paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.
Documentation is for the correct beneficiary and date of service. Documentation includes physicians order for date(s) of service when medication(s) were administered, to include the medication name, dosage, frequency, and method of administration.
Under HIPAA (but not all state laws), employers are permitted to ask employees about their vaccine status, but employees are not required to provide that information to their employer. There could, however, be consequences for failing to provide that information to an employer.
Job Aid Date of administration. Vaccine manufacturer. Vaccine lot number. Name and title of the person who administered the vaccine and address of the facility where the permanent record will reside. Vaccine information statement (VIS) Date printed on the VIS. Date the VIS was given to the patient or parent/guardian.
In California, minors who are 12 years old or older do not need their parents consent to receive the Human Papillomavirus (HPV) or Hepatitis B vaccines. They still must have parental consent to receive all other vaccinations.
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For consent to immunisation to the valid, it must be given freely, voluntarily and without coercion by an appropriately informed person who has the mental capacity to consent to the administration of the vaccines in question.
Immunization providers are required by law to record what vaccine was given, the date the vaccine was given (month, day, year), the name of the manufacturer of the vaccine, the lot number, the signature and title of the person who gave the vaccine, and the address where the vaccine was given.

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