Get the free Offer/Declination of Hepatitis B Vaccination - oregon

This document is an offer to Department of Corrections employees for the hepatitis B vaccination, outlining eligibility, side effects, and procedures for acceptance or declination of the vaccine.

How to fill out offerdeclination of hepatitis b

How to fill out Offer/Declination of Hepatitis B Vaccination

1. Obtain the Offer/Declination of Hepatitis B Vaccination form from your employer or relevant health authority.
2. Read the instructions provided on the form carefully.
3. Fill in your personal information, such as your name, job title, and date.
4. Indicate whether you are accepting or declining the vaccination by checking the appropriate box.
5. If accepting, provide any additional required details, such as your preferred schedule for vaccination.
6. If declining, you may need to provide a reason in the designated section.
7. Sign and date the form to certify your decision.
8. Submit the completed form to your employer or the designated health official, ensuring you keep a copy for your records.

Who needs Offer/Declination of Hepatitis B Vaccination?

1. Healthcare workers who have potential exposure to bloodborne pathogens.
2. Individuals working in environments where Hepatitis B vaccinations are recommended by regulations.
3. Employers required to track vaccination status for compliance with OSHA regulations.
4. New employees in healthcare or high-risk facilities.

People Also Ask about

Can an employee decline the hepatitis B vaccine?

If reasons 1, 2, or 3 are used as the basis for not providing the hepatitis B vaccination, the reason must be documented clearly in the employee's medical record. If the employee declines, then the signed declination form must be in the record.

What is a declination form for hepatitis B vaccine?

A hepatitis B declination form is a form your employer may give you to offer you the hepatitis B vaccine option due to the occupational risk of exposure to the virus.

What is a vaccine declination?

document the refusal of one or more recommended immunizations.

What is a declination form?

If reasons 1, 2, or 3 are used as the basis for not providing the hepatitis B vaccination, the reason must be documented clearly in the employee's medical record. If the employee declines, then the signed declination form must be in the record.

What is a vaccine declination form?

document the refusal of one or more recommended immunizations.

For pdfFiller’s FAQs

What is Offer/Declination of Hepatitis B Vaccination?

The Offer/Declination of Hepatitis B Vaccination is a formal document that provides individuals the opportunity to accept or decline a vaccination for hepatitis B, commonly for those in occupational settings exposing them to blood or bodily fluids.

Who is required to file Offer/Declination of Hepatitis B Vaccination?

Employees who are at risk of exposure to blood or bodily fluids, such as healthcare workers, are required to file the Offer/Declination of Hepatitis B Vaccination.

How to fill out Offer/Declination of Hepatitis B Vaccination?

To fill out the Offer/Declination form, individuals should provide their personal information, indicate whether they accept or decline the vaccination, and sign and date the document to confirm their decision.

What is the purpose of Offer/Declination of Hepatitis B Vaccination?

The purpose of the Offer/Declination of Hepatitis B Vaccination is to ensure that individuals are informed about the vaccine's availability and to document their acceptance or refusal for healthcare compliance and safety records.

What information must be reported on Offer/Declination of Hepatitis B Vaccination?

The information that must be reported includes the individual's name, position, the date of the offer, their signature indicating acceptance or declination, and any relevant medical or exposure history if applicable.