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BiMart VACCINE ADMINISTRATION RECORD (vU2011). PATIENT: Please Complete The Following Print Name: Date of Birth: / / Age: Home Street Address: City, State & Zip: Home Phone: Primary Care Physician:.

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Job Aid Date of administration. Vaccine manufacturer. Vaccine lot number. Name and title of the person who administered the vaccine and address of the facility where the permanent record will reside. Vaccine information statement (VIS) Date printed on the VIS. Date the VIS was given to the patient or parent/guardian.

Several vaccines are so common that they are generally known by their initials: MMR (measles, mumps, and rubella) and DTaP (diphtheria, tetanus, and pertussis). Each protect your child against three diseases.

Abbreviations are listed alphabetically. Click a button below to “jump” to that section. JEJapanese EncephalitisMenB-4CSerogroup B meningococcal vaccine (®)MMRMeasles, Mumps & Rubella VaccineMMRVMeasles, Mumps, Rubella & Varicella VaccineMPSV4Meningococcal Polysaccharide Vaccine (Quadravalent)12 more rows

Measles, Mumps, Rubella (MMR) Vaccine.

The dosage for MMR vaccine is 0.5 mL by the subcutaneous route. If a second dose is indicated, the minimum interval between the first and second doses should be separated by at least 4 weeks (28 days). The preferred injection site for adults is the posterior triceps aspect of the upper arm.

To reconstitute, use only the diluent supplied with the vaccine since it is free of preservatives or other antiviral substances which might inactivate the vaccine. Withdraw the entire volume of the supplied diluent from its vial and inject into lyophilized vaccine vial. Agitate to dissolve completely.

If you're unsure whether you've been vaccinated, you should first try to find your vaccination records. If you do not have written documentation of MMR vaccine, you should get vaccinated. The MMR vaccine is safe, and there is no harm in getting another dose if you may already be immune to measles, mumps, or rubella.

® is a combination measles, mumps, and rubella (MMR) vaccine manufactured by GlaxoSmithKline Biologicals (GSK). ProQuad® is a combination measles, mumps, rubella, and varicella (MMRV) vaccine.

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© Copyright 1997-2025
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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