Form

Hepatitis B: requesting issue of immunoglobulin for infants

Form for antenatal departments to request issue of hepatitis B immunoglobulin for infants at risk of hepatitis B infection by perinatal transmission.

Document

Issue of immunoglobulin for infants at risk of hepatitis B infection

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

This form is for use by healthcare professionals to request immunoglobulin for infants at risk of hepatitis B infection. For multiple births please complete a form for each infant.

Send completed request form to:

Public Health England

Hepatitis B Infant Study Coordinator
Immunisation Department
61 Colindale Avenue
London
NW9 5EQ

Published 24 June 2014
Last updated 16 November 2017 + full page history
  1. Revised request form to highlight the need to complete separate forms for each infant from a multiple birth.
  2. First published.