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department of athletics policies & procedures - UNC Wilmington ...

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FORM F:<br />

THE UNIVERSITY OF NORTH CAROLINA WILMINGTON<br />

DEPARTMENT OF ATHLETIC TRAINING<br />

EMPLOYEE HEPATITIS B VACCINATION LIST<br />

Name<br />

Job Title<br />

Vaccination<br />

Received (√)<br />

Vaccination<br />

Declined (√)<br />

This form pertains to the requirements <strong>of</strong> the OSHA Standard on Occupational Exposure to<br />

Blood borne Pathogens as appears in the Federal Register, December 6, 1991, 29 CFR Part<br />

1910.1030.<br />

173

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