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Hepatitis B Vaccination Declination Montana Tech of The University of Montana I, the undersigned employee, understand that due to my potential for occupational exposure to blood or other potentially.

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Related content

PDF - 9.64 MB - 172 pages - CDC
Oct 15, 2019 — Tom Schwan, Hamilton, Montana, USA. Frederic E. ... oral poliovirus...
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View Hepatitis B Vaccination Declination Form
1300 W. Park Street | Butte, MT 59701 | mtech.edu | 406.496.4463. Hepatitis B Vaccination...
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MI MDCH/BCAL-3305 2012 CA EJ-100 1983 MountainStar Medical Group Release of Medical Records University of Louisville Application for Replacement Diploma

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The hepatitis B vaccine is recommended for all infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults age 19 through 59 years, and adults age 60 years or older with risk factors for hepatitis B infection.

Adults. All adults aged 19 through 59 years, and 60 years and older with risk factors for hepatitis B should get the hepatitis B vaccine. The vaccine is given in 3 doses. The second dose is given 1 month after the first dose, followed by a third dose 6 months after the second dose.

Risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. Chronic hepatitis B can lead to serious health issues, like cirrhosis or liver cancer. Learn more about hepatitis B.

An employee has a right to refuse the vaccination. If you do, however, you should realize that without the hepatitis B immunization three-injection series or evidence of immunity from previous viral infection, you remain at risk for acquiring hepatitis B virus (HBV) infection.

DECLINATION: I understand that due to my occupational exposure to blood or other poten tially infectious materials that I may be at risk of acquiring Hepatitis B Virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine.

Routine administration schedule for hepatitis B vaccine in adults. The dosing schedule is 0, 1 to 2 months, and 4 to 6 months. There is some flexibility in the schedule, but be sure to keep in mind the minimum intervals between doses: At least four weeks between doses #1 and #2.

The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all adults aged 19–59 years and adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.

Workers infected with HBV face a risk for liver ailments which can be fatal, including cirrhosis of the liver and primary liver cancer. A small percentage of adults who get hepatitis B never fully recover and remain chronically infected.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232