This customizable document, Consent for Hepatitis B Vaccination Form, is taken from MCN Healthcare’s Human Resources Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

MCN’s templates save you time, money and resources, rather than developing healthcare policy and procedure manuals from scratch.

Here is some sample content from Consent for Hepatitis B Vaccination Form:

	CONSENT FOR HEPATITIS B VACCINATION I hereby give my consent to be vaccinated against hepatitis B. The complete vaccination series requires three 3 inoculations over a six 6 month period. I have been given information and an opportunity to ask questions about the vaccine and the risks involved. All my questions have been answered to my satisfaction. I understand that I should not take the vaccine if pregnant or nursing because the effects at this time are unknown. I further understand that I should not take the vaccine if I have an active infection or if I am allergic to any components...
Second excerpt:
	...take the vaccine if pregnant or nursing because the effects at this time are unknown. I further understand that I should not take the vaccine if I have an active infection or if I am allergic to any components of the vaccine. Signature individual to receive vaccine Witness licensed personnel TEST RESULTS Date: HEPATITIS B VACCINE SERIES DOCUMENTATION: Initial Dose: Given By: Comments: 1-Month Dose: Given By: Comments: 6-Month Dose: Given By: Comments:...