Vaccine Refrigerator Temperature Log PDF by xyi12027

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									                                     Massachusetts Department of Public Health
                                            Vaccine Management Unit
      51670                              305 South Street, Jamaica Plain, MA 02130
                                                                                                  Received in Vaccine Unit:
  v3.0 - 4/1/2008                         Phone: 617-983-6828 Fax: 617-983-6924
                                                                                                       /       /

Vaccine Refrigerator Temperature Log
Site No:   (VACMAN ID)               Site Name:



Date Submitted:     (mm.dd.yyyy)
                                   FAX all temperature logs from previous month along with vaccine order and usage
      .         .                  forms.Temperature should be (2 C to 8 C) or (35 F to 46 F).

Month _____ Year _____                   A.M. Temp              Initials              P.M. Temp                 Initials
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If your refrigerator or freezer is out of temperature range, immediately contact the MDPH Vaccine Management
                     Unit at (617) 983-6828 to determine if any vaccines have been damaged.

								
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