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Get UIS Hepatitis A Vaccine Administration Record

IAL SECURITY # zip county TELEPHONE (217) (Daytime) “I have read or have had explained to me information provided by the Campus Health Service regarding Hepatitis A and its vaccine. I have had a chance to ask questions that were answered to my satisfaction. I believe I understand the benefits as well as the risks of the Hepatitis A vaccine, and I have given permission to have the vaccine administered to me.” SIGNATURE X TODAY’S DATE FOR CLINIC/OFFICE USE ONLY Date Vaccine Administe.

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Keywords relevant to UIS Hepatitis A Vaccine Administration Record

  • administered
  • hepatitis
  • Administrator
  • manufacturer
  • Vaccine
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