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Test/Immunization Record - DIGITAL FORM

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$110.00
SKU: 2123E
$110.00

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Updated 2021

Briggs Test/Immunization Record provides for documentation of tuberculin testing/screening and immunizations/vaccinations routinely provided in a post-acute care setting: AL, SNF/NF, RCF, etc.

Prompts for documentation include date, who administered the test or the vaccination, consent, site, lot number, expiration date and results/reactions.

Includes: 

         TB Screening

         COVID-19 Vaccines and Boosters

         Pneumococcal Vaccines -  PPSV23, PCV13, PCV20

         Influenza Vaccines - Standard Trivalent, High Dose Trivalent, Quadrivalent, Other

         Herpes Zoster Vaccines

         Hepatitis B Vaccine

         Hepatitis A Vaccine

         Tetanus/Diphtheria/Pertussis (Td/Tdap) Vaccine

         2 blank spaces left for recording other vaccines not routinely administered for all patients/residents, employees, or volunteers


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*This 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).  After 1- year, your update subscription will automatically renew.

 

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*This 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).  After 1- year, your update subscription will automatically renew.

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