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Hepatitis b form for employees

Hepatitis b vaccine documentation form 2025

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The document is a consent form for Hepatitis B vaccination, outlining the benefits, risks, and voluntary nature of the vaccination process for employees with occupational blood exposure. It details the requirement of three doses over six months to achieve immunity and emphasizes that participation is voluntary without affecting employment rights. Additionally, it includes a declination statement for those who choose not to receive the vaccine, acknowledging their continued risk of Hepatitis B infection.

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Click ‘Get Form’ to open the hepatitis B vaccination consent form in the editor.
Begin by entering your full name in the designated field. This ensures that your consent is properly attributed.
Next, provide your Social Security Number in the appropriate section. This information is necessary for record-keeping purposes.
Review the consent statement carefully. Ensure you understand the benefits and risks associated with the vaccination before proceeding.
Sign and date the form in the specified areas to confirm your consent for receiving the vaccine.
If you choose to decline vaccination, navigate to the declination statement section, sign, and date it accordingly.
Finally, check the box if you have already received the Hepatitis B vaccination series before submitting your form.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the full series of hepatitis B vaccine?

The United States Food and Drug Administration (FDA) has licensed two single-antigen hepatitis A vaccines (Havrix and Vaqta) and one combination vaccine for protection against both hepatitis A and hepatitis B (Twinrix) for use in the US.

What is the full name of hepatitis B?

The hepatitis B vaccine is an injection (or shot) that is generally given in the arm as a three-dose series on a 0, 1, and 6-month schedule. Alternative schedules may be considered, noting that a third dose at 6 months, meeting minimum intervals between doses, is needed for maximum, long-term protection.

What is a declination form for the hepatitis B vaccine?

A hepatitis B declination form is a form your employer may give you to offer you the hepatitis B vaccine option due to the occupational risk of exposure to the virus.

What is the full form of the hepatitis B vaccine?

What is a hepatitis B vaccine? A hepatitis B vaccine prevents hepatitis B virus infection (HBV). Engerix-B, Heplisav-B, and Recombivax HB (all brand names) are examples of hepatitis B vaccines approved by the U.S. Food and Drug Administration (FDA).

What is the doc for hepatitis B?

Doctors who specialize in treating hepatitis B include: Doctors called gastroenterologists, who treat digestive diseases. Doctors called hepatologists, who treat liver diseases. Doctors who treat infectious diseases.