Transcription of Vaccine Refrigerator Temperature Record
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Vaccine Refrigerator Temperature Record
Vaccine Storage Unit Temperature Record20706 (Rev2022-06) SiteMonthVaccine Storage UnitYearDateTimeCurrent TempMaximum TempMinimum TempInitial TimeCurrent TempMaximum TempMinimum TempInitial12345678910111213141516171819 20 Page 1 of 3 Vaccine Storage Unit Temperature Record20706 (Rev2022-06) SiteMonthVaccine Storage UnitYearDateTimeCurrent TempMaximum TempMinimum TempInitial TimeCurrent TempMaximum TempMinimum TempInitial2122232425262728293031 Weekly AuditDateInitialsInitials and Printed Name of RecorderInitialsPrinted NameInitialsPrinted NamePage 2 of 3 NotesVaccine Storage Unit Temperature Record20706 (Rev2022-06) a new form for each new in the site and Vaccine storage unit serial number (or other identifying information, Fridge #1,Freezer #1, etc.)
temperature logs weekly to ensure proper temperature recording and note trends. • Retain this record for 5 years. If the temperature is BELOW +20 or ABOVE +80 Celsius Call your Zone Vaccine Contact as soon as possible following identification of temperature excursion. • Label vaccine “Do Not Use” and move to a functioning refrigerator.
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