CONTACTS Sexual / Address /tel. no. Vaccinated HBIG household / Details of Vaccination Name DOB previously required (if not household other exposure arranged (Y/N) (Y/N/DK) (Y/N) contact) (S/H/O) Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O Y/N Accelerated / Y/N/DK Y/N S/H/O
CONTACTS Name Address /tel. no. (if not household contact) DOB Sexual / household / other (S/H/O) Details of exposure Vaccinated previously (Y/N/DK) Vaccination arranged (Y/N) HBIG required (Y/N) S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N S/H/O Y/N/DK Y/N Accelerated / Y/N