The form consists of at least 6 pages. The first section is to be completed by the student. It's basically just a checklist of things to get done. Section 2 is done by the office so that you can get cleared to the program. If you're not cleared the form is sent back to you, and you have to make sure everything is done, or else you don't continue.
Section 3: tetanus/ diptheria. you have to get a shot within ten yr. span. If it's been that long, you have to get a new one.
Section 4: Measles, Mumps, and Rubella. you have to be immune with these three, and this is done through blood titres. If one's not immune, they give an MMR vaccination Varicella. If blood tests show that you're not immune, you have to take 2 vaccinations. The second one has to be at least 28 days after your first shot.
Section 5: Hep B. Basically, if you're not immune, you get three shots. In order to get cleared into the program, you have to at least have done two shots out of three. Your last shot can be done after you have been cleared and the paper is given back to you. (Make sure you bring your paper back though, after completing it). If in any way, you're still not immune after those 3 shots, you have to complete Part A or Part B (whichever one applies to you).
Section 5: TB Screening. You have to get a TB shot (I think this is 42$ now) and if it reads positive, you have to go and get a Chest Xray.
Section 6: very straight forward, get all your HCPs who have participated in your immunization to sign it.
P.S. I do believe there's a cost in HepB shots. I just had to take HepA and HepB so the price of that is a bit different. Just ask an HCP, and they can help you with that.
P.P.S. And yes, it is better to take the form with you every time you see the doctor. That way, you can keep track of things that have been done, and things that have yet to be done! Good luck! : )
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Maria Rueda.
BScN, L3, McMaster
CA Les Prince Hall 10/11; Bates '09/10
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