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This document serves as a record and consent form for the administration of the influenza vaccine for employees and nonemployees of Northern Light Health.
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How to fill out influenza vaccine administration record
How to fill out influenza vaccine administration record
01
Begin by entering the date of vaccine administration.
02
Record the name of the vaccine given.
03
Write down the manufacturer's name.
04
Note the lot number of the vaccine.
05
Indicate the expiration date of the vaccine.
06
Fill in the site of administration (e.g., left arm, right thigh).
07
Include the name and signature of the healthcare provider administering the vaccine.
08
Document any adverse reactions if applicable.
Who needs influenza vaccine administration record?
01
Individuals receiving the influenza vaccine.
02
Healthcare providers administering the vaccine.
03
Parents or guardians for minors receiving the vaccine.
04
Employers or facilities that require vaccination documentation.
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What is influenza vaccine administration record?
The influenza vaccine administration record is a documentation form used to record details about the administration of the influenza vaccine, including the date, vaccine type, and recipient information.
Who is required to file influenza vaccine administration record?
Healthcare providers and clinics that administer the influenza vaccine are required to file an influenza vaccine administration record for each vaccination given.
How to fill out influenza vaccine administration record?
To fill out the influenza vaccine administration record, enter the recipient's name, date of birth, vaccination date, vaccine lot number, manufacturer, and the administrator's details, ensuring all information is accurate and complete.
What is the purpose of influenza vaccine administration record?
The purpose of the influenza vaccine administration record is to maintain accurate vaccination records for individuals, facilitating tracking of immunization status and ensuring compliance with public health requirements.
What information must be reported on influenza vaccine administration record?
The information that must be reported includes the recipient's details (name, date of birth), vaccination date, vaccine type, manufacturer, lot number, and the name and title of the person administering the vaccine.
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