Test/Immunization Record - DIGITAL FORM
Electronically Delivered eForm* - Available Now – Subscribe Today
Briggs Digital forms:
-Updates included with annual subscription
-Form-fillable PDF documents at your fingertips
-Easy to complete on any device
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.
• 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
*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.