Awasome Flu Vaccine Administration Record Template

To Record Influenza, Pneumococcal, Zoster, Hib, And Other Vaccines (E.g., Travel Vaccines).

Flu vaccine administration record if you are receiving your flu vaccine from an outside provider, please ask them to document all required information listed below. ⧠ continue with vaccine administration ⧠ vaccination not given (see. Understand the benefits and risks of the vaccine and request that the vaccine indicated on this form be given to me or the person named on this health record for who i am authorized to.

Information And Screening Question Responses.

This vaccine is appropriate for this patient based on the responses to the screening questions and age guidelines according to acip. Immunization information system (iis) or “registry”: What can you do to protect from the flu?

Before Administering Any Vaccines, Give The Patient Copies Of All Pertinent Vaccine Information Statements (Viss) And Make Sure He/She Understands The Risks And Benefits Of The Vaccine(S).

A list of coordinators can be found under common documents on the flu. Record the generic abbreviation (e.g., tdap) or the trade name for each vaccine (see table at right). Complete all requested information for each vaccine administered.

Health Care Providers Who Administer Vaccines Covered By The National Vaccine Injury Compensation Program (Vicp) Are Required Under The National Childhood Vaccine.

Update demographic information and complete at each vaccine administration. ** please forward flu vaccine records to your member flu vaccination coordinator. (pdf 1.52 mb) (english and spanish) (updated october 2018) vaccine ordering, storage and handling.

Record The Date Of Vaccination And The Name/Location Of The Administering Clinic.

We want to make certain that you have information about the vaccines or antibody product we administered so you can update your patient’s medical record. Flu offline vaccination record form1. Enter vaccine lot #, expiration date and site of administration, then scan the.