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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.
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.
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.
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.
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).
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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.

hep b vaccine consent form