Form F-44702 Vaccine Administration Record - Wisconsin

Form F-44702 Vaccine Administration Record - Wisconsin

What Is Form F-44702?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-44702?
A: Form F-44702 is the Vaccine Administration Record for the state of Wisconsin.

Q: What is the purpose of Form F-44702?
A: Form F-44702 is used to document the administration of vaccines in Wisconsin.

Q: Who uses Form F-44702?
A: Healthcare providers in Wisconsin use Form F-44702 to record vaccine administrations.

Q: What information is included in Form F-44702?
A: Form F-44702 includes information about the vaccine type, lot number, date of administration, location, and healthcare provider details.

Q: Is Form F-44702 mandatory?
A: Yes, healthcare providers in Wisconsin are required to use Form F-44702 to record vaccine administrations.

Q: Can individuals access their own Form F-44702?
A: Yes, individuals can request a copy of their Form F-44702 from the healthcare provider who administered the vaccine.

Q: Is there a fee to obtain Form F-44702?
A: The cost of obtaining Form F-44702 may vary depending on the healthcare provider.

Q: Can Form F-44702 be used for vaccines administered outside of Wisconsin?
A: Form F-44702 is specific to vaccines administered in Wisconsin and may not be applicable for vaccines administered outside of the state.

Q: What should I do if there is an error on my Form F-44702?
A: If there is an error on your Form F-44702, you should contact the healthcare provider who administered the vaccine to request a correction.

ADVERTISEMENT

Form Details:

  • Released on October 1, 2010;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form F-44702 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-44702 Vaccine Administration Record - Wisconsin

4.5 of 5 (20 votes)
  • Form F-44702 Vaccine Administration Record - Wisconsin

    1

  • Form F-44702 Vaccine Administration Record - Wisconsin, Page 2

    2

  • Form F-44702 Vaccine Administration Record - Wisconsin, Page 1
  • Form F-44702 Vaccine Administration Record - Wisconsin, Page 2
Prev 1 2 Next
ADVERTISEMENT