Hepatitis B Form
Introduction of New Form
ROHP is replacing the former web-based Hepatitis B Vaccine Series Authorization for Services form with a downloadable form which can be completed and saved on your local hard drive or other storage device.
How do I access this new form?
This form can be downloaded from the ROHP website by clicking on any of the Form titles and saved on your local hard drive or other storage device. When completed, the form(s) should be sent to ROHP either by email to firstname.lastname@example.org or faxed to the ROHP secure electronic fax number 617-977-8788.
This form is to be used by Principal Investigators. The Principal Investigator is responsible for identifying researchers who may become exposed to a blood borne pathogen when working with human blood or cerebral, synovial, pleural, peritoneal, pericardial and amniotic fluids or unfixed human tissue, human derived cell lines and human cell cultures. The Hepatitis B vaccine is made available to researchers at no cost. Those researchers choosing not to receive the vaccine must sign a declination form.
Note: Hepatitis B Virus has been demonstrated to survive in dried blood at room temperature on environmental surfaces for at least a week.