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Document every COVID-19 vaccine with accuracy


COVID-19 vaccination providers must document vaccine administration in their medical record systems within 24 hours of giving a dose. In addition, they must use their best efforts to report dispensing data to the relevant system for the jurisdiction (i.e., IIS) as soon as practicable and no later than 72 hours after the dose has been administered.

The two COVID-19 Vaccine Recordkeeping forms below allow your facility to record all the details of each COVID-19 vaccine administered, including when the second dose will be and a reminder for your patient.

The product is a two-part form that includes a self-adhesive label and an exact duplicate record sheet for you to:

1. Give the label to the patient or place it in their chart.

2. Keep the record sheet as a chronological log of every vaccine.

We can alter either of these designs OR design something completely new for you. We can add or delete any wording on your product, whether you're ordering for the first time or reordering, for no additional charge. Before going to press with your order, we will email or fax a proof of your design for you to approve.

Design #1 - you get a record for the chart (left) and a reminder card for the patient (right).

COVID Vaccine Record and Reminder
SKU: #S120
$93 (sets with duplicate copy)
250 vaccine record labels and reminder cards, 5 records per page
Comes in an 8.5” x 11” book.

Design #2 - you get a record for the chart and a chronological duplicate log.

COVID Vaccine Record Label
SKU: #S122
$228 (sets with duplicate copy) or $178 (labels only)
700 labels per box, 7 labels per page

Call 800-243-1969 today to order!

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