b. Entries for smallpox, yellow fever, and cholera will be authenticated by the
Department of Defense Immunization Stamp and the actual signature of the medical
officer (M.D.) or his designated representative who will sign his/her name over the
physician's stamped, printed, or typed name and facility address. Origin and batch
number will also be recorded for yellow fever and smallpox.
c. Entries on PHS Form 731 may be based on:
(1)
Immunization administered at the preparing facility.
(2)
Transcripts from official records.
(3) Transcripts from written statement of civilian physicians if sufficient
information is provided.
1-25. STANDARD FORM 601 (SF 601)
Standard Form 601 will be prepared and permanently maintained in the record
for each individual for whom an outpatient treatment record is maintained. Individuals
preparing the SF 601 and PHS 731 will ensure that appropriate entries are recorded on
both forms and that both forms have the same information.
1-26. PHS FORM 731 AND SF 601
a. For both records, written statements from civilian physicians attesting to
immunization with approved vaccines giving dates and dosages may be accepted as
immunization. Be sure information is transcribed to official records.
b. Booster immunizations for all such completed series will be administered to
maintain a common immunologic level.
1-27. DESIGNATED REPRESENTATIVE FOR THE MEDICAL OFFICER
All individuals designated as representatives for the medical officer will be
registered nurses, hospital corpsmen/medical technicians, or physician assistants.
Such persons will have had special indoctrination in the administration and technical
aspects of immunization procedures. Medical officers on the staffs of major commands
or commanding officers of medical treatment facilities will compile and maintain a
current list of persons authorized to administer immunizations. These records will be
available for review and inspection.
1-28. SPECIFIC ENTRIES
Entries for tetanus-diphtheria toxoid will be recorded as Td or TD, depending on
the dose. Tetanus toxoid is recorded as Tt, although there are extremely few cases
where tetanus toxoid alone would be preferred over a tetanus/diphtheria combination.
MD0587
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