Form 57.75Y Healthcare Worker Vaccination History

The National Healthcare Safety Network (NHSN)

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0666 can be found here:

Document [ppt]

Download: ppt | pdf

File Type	application/vnd.ms-powerpoint
File Title	Slide 1
Author	Jasie L. Jackson
Last Modified By	rfp9
File Modified	2007-07-26
File Created	2007-04-19