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  • Hepatitis B Vaccine Documentation Form

Get Hepatitis B Vaccine Documentation Form

HEPATITIS B VACCINE DECLINATION/DOCUMENTATION * Please complete option I or II prior to your assignment * I. DECLINATION OF HEPATITIS B VACCINE I am refusing the Hepatitis B Vaccine and hold harmless.

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How to fill out the Hepatitis B Vaccine Documentation Form online

Filling out the Hepatitis B Vaccine Documentation Form online is a vital step in ensuring your health and safety in the workplace. This guide will walk you through the process with clear and supportive instructions.

Follow the steps to accurately complete your documentation

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Review whether you will select option I or option II on the form. Option I is for declination of the Hepatitis B vaccine, while option II is for documentation of vaccine series received.
  3. If you choose option I, clearly state your intention to decline the Hepatitis B vaccine. Make sure to understand the risks associated with declining, particularly due to occupational exposure.
  4. For option I, sign and date the form at the specified section indicating your declination.
  5. If you choose option II, confirm that you have received the complete Hepatitis B Vaccine series and provide documentation as proof. Attach any relevant documentation that validates your vaccination.
  6. If applicable, provide written proof of immunity, previous vaccinations, or medical contraindications by attaching the necessary documentation.
  7. In both options, ensure that your signature and date are included at the designated sections of the form.
  8. After filling out the form completely, you may save changes, download a copy for your records, print a hard copy, or share it as required.

Complete your Hepatitis B Vaccine Documentation Form online today to ensure your health and compliance.

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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.

In addition, employers must make hepatitis B vaccination available to these workers. 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.

View larger image The hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with hepatitis B virus. The hepatitis B vaccine is given as a series of three shots. The first dose is given within 24 hours of birth.

Most people who are vaccinated with hepatitis B vaccine are immune for life. Hepatitis B vaccine is usually given as 2, 3, or 4 shots. Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6–18 months of age.

The HepB injection usually creates long-term immunity. Most infants who get the HepB series are protected from hepatitis B infection beyond childhood, into their adult years. Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer.

Hepatitis B Virus (HBV) HBV is a small, double-stranded DNA virus in the family Hepadnaviridae. Serologic markers for HBV infection include HBsAg, antibody to HBsAg (anti-HBs), immunoglobulin class M (IgM) antibodies to hepatitis B core antigen (IgM anti-HBc), and immunoglobulin class G (IgG) anti-HBc (IgG anti-HBc).

View larger image The hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with hepatitis B virus. The hepatitis B vaccine is given as a series of three shots. The first dose is given within 24 hours of birth.

Reducing HBV infections and deaths by 2030 Vaccines can help prevent the disease and have reduced the number of reported hepatitis B cases by 90% since being introduced in 1982. A hepatitis B vaccine is now recommended for adults ages 19 to 59 years without risk factor screening and disclosure.

anti-HBs or HBsAb (Hepatitis B surface antibody) - A "positive" or "reactive" anti-HBs (or HBsAb) test result indicates that a person is protected against the hepatitis B virus. This protection can be the result of receiving the hepatitis B vaccine or successfully recovering from a past hepatitis B infection.

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Fill Hepatitis B Vaccine Documentation Form

I have already been vaccinated against the Hepatitis B virus. I have been given the opportunity to be vaccinated with the Hepatitis B vaccine; however I decline Hepatitis B vaccination at this time. Purpose: To document the Hepatitis B vaccination status of the employee. The purpose of this document is to provide information on the Hepatitis B vaccination, efficacy, safety, method of administration, and benefits. This form is to be used where a hepatitis B vaccination record is not available. Please download the form before filling it in. I have been given the opportunity to be vaccinated with Hepatitis B vaccine. In addition, I have re ceived information regarding the Hepatitis B (HBV) vaccine. This Form has three purposes: 1. Learn hepatitis B vaccine recommendations, precautions, administration and more.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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