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IMM1052 State (8/14). DATE: REFRIGERATOR. FREEZER. VACCINE. BRAND. DOSES. PER BOX. LOT NUMBERS. EXPIRATION. DATE. # DOSES. ON HAND.

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How to fill out the Imm 1052 online

The Imm 1052 form is essential for maintaining accurate records of adult vaccines and assisting with vaccine ordering. This guide will help you navigate the form step-by-step to ensure you provide all required information correctly.

Follow the steps to successfully complete the Imm 1052 form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in your editing tool.
  2. Fill in the date at the top of the Imm 1052 form, ensuring it reflects the current date.
  3. In the refrigerator section, enter all vaccine brand names as listed, specifying the doses per box. Be sure to record the lot numbers and expiration dates corresponding to each product.
  4. Document the total doses on hand for each vaccine type, including Hepatitis B, IPV, MCV, Td, and Tdap, under the LOT NUMBERS and DOSES ON HAND columns.
  5. For the freezer section, similarly list the vaccines along with their details, ensuring accuracy in the counts and expirations.
  6. Once you have completed all necessary fields, review the information for accuracy and completeness.
  7. Finally, save your changes, and you can choose to download, print, or share the completed form as needed.

Complete your Imm 1052 form online today to maintain proper vaccine records.

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Live, attenuated injectable vaccines (e.g., MMR, varicella, yellow fever) and certain non-live vaccines (e.g., meningococcal polysaccharide) are recommended by the manufacturers to be administered by subcutaneous injection.

The most common medications given by IM route include: Antibiotics- G benzathine , . Biologicals- immunoglobins, vaccines, and toxoids. Hormonal agents- , [2]

To be eligible, children must be 18 years of age or younger and meet any one of the following criteria: 1. Eligible for Medi-Cal or Child Health and Disability Program (CHDP) 2. Uninsured 3.

Vaccines given IM (intramuscular) route: DTaP, DT, Hib, hepA, hepB, HPV, IIV, MCV, PCV, rabies, Td, Tdap and RZV (Shingrix). Administer IPV and PPSV vaccines either via IM or SQ (subcutaneous) route.

Hib vaccines ( and Act-HIB) HPV (human papillomavirus) vaccine. IPV (inactivated poliovirus)–containing combination vaccines — combination vaccines containing IPV are given intramuscularly; IPV (IPOL) is given subcutaneously.

For infants and younger children receiving more than two injections in a single limb, the thigh is the preferred site because of the greater muscle mass. For older children and adults, the deltoid muscle can be used for more than one intramuscular injection.

COVID-19 vaccine is administered by intramuscular injection. Choose the correct equipment.

The flu shot is usually given as an intramuscular (IM) needle injection into the upper, outer arm muscle called the deltoid muscle in people 3 years of age and older.

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© Copyright 1997-2026
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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
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
altaFlow
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 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232