HBV Vaccine Consent/Declination- Employee – DIGITAL FORM
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Updated 2021
Briggs Hepatitis B Vaccine Consent/Declination form provides for documentation required by OSHA of employee information, consent, or declination. The VIS was updated by CDC on October 15, 2021 (URL for the VIS provided on this form).
The HBV Vaccination Record for the employee is found on the reverse side of the form.
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*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. This digital form is delivered as a form-fillable PDF and includes 1-year of updates. To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment) and provide the facility/agency address. After 1- year, your subscription will automatically renew.
All Briggs Digital on Demand products require a credit card payment (or pre-payment) to receive digital files electronically.
Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.