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Employment Information

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Additional Information

Hepatitis B. Vaccine Determination
I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring the Hepatitis B virus (HBV) infection. I understand that upon exposure, I am to contact the office immediately and a confidential medical evaluation and follow-up will then be made available. Included in this medical evaluation will be the opportunity to receive the Hepatitis B Immune Globulin (HBIG) vaccination at no charge to me. This is not the three series shot, and will only be administered if you are exposed to infectious materials.

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