Get 57.214 Healthcare Personnel Influenza Vaccination Summary Form - Cdc

This guide provides a comprehensive overview of the 57.214 Healthcare Personnel Influenza Vaccination Summary Form, detailing how to accurately fill it out online. Whether you are a healthcare professional or administrator, these instructions will assist you in completing the form with confidence.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the healthcare personnel influenza vaccination summary form and open it in your chosen online editor.
2. Begin by entering your facility ID number in the designated field. This identifier is crucial for tracking vaccination data.
3. Specify the vaccination type. For this form, select 'Influenza' to indicate the vaccination being reported.
4. Choose the influenza subtype from the options provided. For the CDC's reporting, select 'Seasonal' as it is the applicable choice.
5. Indicate the influenza season for which you are reporting. The date format should be in the form of 'MM/DD/YYYY'.
6. For each healthcare personnel (HCP) category listed, record the number of individuals who fit the criteria for each field, including licensed independent practitioners, employees, adult students, trainees, volunteers, and other contract personnel.
7. Complete the fields for questions 1 through 6, ensuring to count HCP accurately based on the criteria outlined in the form notes, particularly regarding seasonal reporting.
8. Use the custom fields section to provide any additional relevant information or specific counts that may not fit the standard categories.
9. Include comments or notes in the comments section, if necessary, to clarify any entries or to provide context for the data reported.
10. After filling out all sections of the form, choose to save your changes, download a copy, print the form for your records, or share it as needed.

Complete your 57.214 Healthcare Personnel Influenza Vaccination Summary Form online today for accurate health tracking.