Get Immunization Documentation Form - Yale-new Haven Hospital - Ynhh

Filling out the Immunization Documentation Form for Yale-New Haven Hospital is an essential step in ensuring accurate health records. This guide provides clear instructions for users to complete the form online with ease and confidence.

Follow the steps to fill out the Immunization Documentation Form accurately.

1. Press the ‘Get Form’ button to access the Immunization Documentation Form and open it in your editor.
2. Complete the 'Name' field with your full legal name. It's essential that this matches your identification documentation.
3. Fill in your 'Date of Birth' (D.O.B.) in the specified format. Ensure that the date is clear and accurate.
4. In the 'Documentation of Immunizations/Titers' section, input information about each vaccine or titer, including the date received and the result.
5. Follow the format for 'History of Natural Infection?' for each vaccination entry. Indicate if you have a history of natural infection. If not applicable, again use 'N/A'.
6. For the PPD/Mantoux question, answer if you have had a test within the last year. If results are positive, ensure to include the chest x-ray results and indicate any prophylactic therapy received.
7. Once all relevant fields are completed, review the information for accuracy. Make any necessary changes.
8. Save your changes to the document. Additionally, you can download, print, or share the completed form as needed.

Complete your Immunization Documentation Form online today to ensure your health records are up-to-date.