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  • Hepatitis B Declination Form Print Out

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Ith human blood or other potentially infectious materials as outlined in the University of New Hampshire s Bloodborne Pathogen Exposure Control Plan. HEPATITIS B VACCINATION ACCEPTANCE/DECLINATION STATEMENT 2. In full recognition of the above (check one of the following): I have already received the HBV vaccination series on: . Date/Year I decline participation in the vaccination series. I understand that due to my occupational exposure to blood or other potential.

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How to fill out the Hepatitis B Declination Form Print Out online

Filling out the Hepatitis B Declination Form is an important step for individuals working with potentially infectious materials. This guide provides clear, step-by-step instructions to assist you in completing the form online accurately and efficiently.

Follow the steps to complete the Hepatitis B Declination Form online.

  1. Click ‘Get Form’ button to access the document and open it in your online editor.
  2. In section 1, acknowledge that you have received training on the risks associated with human blood and other potentially infectious materials by checking the appropriate box.
  3. Move to section 2, where you must indicate your choice regarding the Hepatitis B vaccination. You can select one of the three options provided: confirm if you have received the vaccination series, decline the vaccination, or accept participation in the vaccination program.
  4. If you are declining the vaccination, ensure you understand the implications of your decision. Check the box and read through the statement provided regarding the risks and the opportunity for future vaccination.
  5. In the designated fields, enter your printed name, provide your signature, state your department, and fill in the date of completion.
  6. Review the completed form for accuracy, save your changes, and choose to download, print, or share the form as needed.

Complete your Hepatitis B Declination Form online now for a safe and compliant work experience.

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The body normally produces antibodies to HBsAg as part of the normal immune response to infection. HBsAg is the antigen used to make hepatitis B vaccine. Hepatitis B surface antibody (anti-HBs): The presence of anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection.

In most places in the world, infants are vaccinated against the disease shortly after birth, although some booster shots are required to maintain effectiveness over a period of six months.

Employers must ensure that workers who decline vaccination sign a declination form. The purpose of this is to encourage greater participation in the vaccination program by stating that a worker declin- ing the vaccination remains at risk of acquiring hepatitis B.

Declination Statement If, in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

4.2 UNIVERSAL PRECAUTIONS It is recommended that the following precautions be practised when contact with blood and body fluids is anticipated. Barrier precautions: - Wear gloves, aprons, lab coats and other protective clothing as needed.

In 2003, chronic HBV infection became nationally notifiable and is reportable by state health departments to NNDSS. All states are encouraged to report chronic hepatitis B infection.

Hepatitis B Vaccine Recommendations The hepatitis B vaccine is recommended for all infants and children up to age 18 years by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). The CDC also recommends that adults in high-risk groups be vaccinated (see below).

If you do not complete the series, you will not have adequate, longterm protection from hepatitis B.

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