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  • P2023 2023

Get P2023 2023-2025

Vaccine Information Statements (VISs) and make sure they understand the risks and benefits of the vaccine(s). Always provide or update the patient s personal record card. Vaccine Type of Vaccine1 Date vaccine Funding given Source (mo/day/yr) (F,S,P)2 Vaccine Information Statement (VIS) Vaccine Site3 Lot # Mfr. Date on VIS4 Date given4 Vaccinator5 (signature or initials and title) Tetanus, Diphtheria, Pertussis (e.g., Tdap, Td) Give IM.3 Hepatitis A6 (e.g., HepA, HepA-HepB) Give I.

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How to fill out the P2023 online

The P2023 form is a crucial document for recording vaccine administration. This guide provides step-by-step instructions to assist you in completing the form accurately and efficiently when submitting it online.

Follow the steps to successfully complete the P2023 form.

  1. Click the ‘Get Form’ button to obtain the P2023 form and open it in your preferred online editor.
  2. Enter the patient's name and birthdate in the designated fields at the top of the form.
  3. Fill in the chart number and practice name and address to identify the medical facility administering the vaccine.
  4. For each vaccine administered, enter the type of vaccine in the specified section, using either the standard abbreviation or trade name as listed.
  5. Document the date the vaccine was given in the format (month/day/year).
  6. Indicate the funding source of the vaccine using F for federal, S for state, or P for private.
  7. Record the site and route of administration, specifying either intramuscular, subcutaneous, or intranasal, along with the administration location (e.g., right arm, left thigh).
  8. Attach or note the Vaccine Information Statement (VIS) details, including the lot number and manufacturer.
  9. Ensure to record the date of the VIS publication and the date it was given to the patient.
  10. Have the vaccinator sign, or use their initials and title, to authenticate the record.
  11. Review the completed form for accuracy, then save changes, download, print, or share the record as necessary.

Complete your documents online for a streamlined and efficient process.

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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
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
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