Hepatitis A & B Consent Form & Vaccine Administration Record 2025

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Hepatitis B vaccination is recognized as an effective defense against HBV infection. The standard requires employers to offer the vaccination series to all workers who have occupational exposure.
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.
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.
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.
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.
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