Occupational Hepatitis B Vaccination Downloadable Pack
For Occupational Hepatitis B vaccination requests please complete the forms below and return them to the Practice:
- Employers Hep B Letter (to be passed to your Employer)
- Employers Hep B Request Form (to be passed to your Employer for completion)
- Patients Hep B Letter (to be read by the Patient)
- Patients Hep B Form (to be completed by the Patient)
The Deepings Practice
Godsey Lane
Market Deeping
PETERBOROUGH
PE6 8DD
Tel: 01778 579000
Dear Sir,
Re : Occupational Hepatitis B (Hep B)
Your employee has requested to have a course of Hepatitis B injections for occupational purposes. This service is not part of the GPs routine NHS responsibilities. In additional to this we are unable to charge our registered patients for the administration of Hep B under our current NHS contract arrangements.
This letter is to clarify that we are only able to provide the Hepatitis B vaccinations. We are NOT providing any occupational health service associated with this vaccination. We need to inform you that:
- That the occupational risk assessment is the responsibility of the employer under Health and Safety Legislation and that the employer will advise the employee on Hepatitis B and other hazards.
- That the employer has recommended this course of Hepatitis B as a result of that assessment
- The contract is for the provision of Hepatitis B vaccination only
- That health promotion advice relating to the vaccination will be given by the Practice
- That the employer will be responsible for the costs of all parts of the service: i.e. vaccinations, blood tests and certification (if they require all parts)
- That the costs are not refundable if the employee does not complete the course
- Any re-vaccination will result in additional costs
- The contract is between the employer and the practice with invoices replicating this – not on a reimbursement basis for the patient
Please find attached a request form for the provision of Hepatitis B vaccinations for your employee. Once we have received your signed request we will issue a VAT invoice and your employee will be contacted to arrange their first appointment once we have received payment in full.
Charges are as follows:
Course of 3 Vaccinations£90.00
Blood Test£34.50
Booster vaccinations£30.00
Further Blood Tests£34.50
Patient does not attend – practice not notified in advance£20.00
If you require any additional information please do not hesitate to contact me.
Yours sincerely
Mrs Jo Kevan
Business Manager
EMPLOYER OCCUPATIONAL HEPATITIS B REQUEST FORM
I, (insert name) ……………………………………………, of (insert name of organisation)
……………………………………………………………….. have completed a risk assessment on the role of our
employee (insert employees name) …………………………………………………….
As a result of my assessment I am requesting a course of Hepatitis B vaccinations for this employee.
I acknowledge that it is the employer who has made the decision to have the employee vaccinated
and that The Deepings Practice is not responsible for any occupational health advice.
I acknowledge that the employer is responsible for the total costs involved with the Hepatitis B vaccination course and I am aware that there will be no refund if the course is not completed. If an employee does not attend a booked appointment without notifying the practice in advance I acknowledge I will be charged an additional £20.00 per missed appointment.
The Course will not continue until full payment has been made.
Should the employees blood test indicate an additional vaccination is required I acknowledge there will be an additional charge of £69.50 for a fourth vaccination and repeat blood test.
Signed ……………………………………………………………….
Position in organisation ………………………………………….
Date …………………………………………………………………….
Please return the completed form to:
Mrs Sue Goodale
Finance Assistant
The Deepings Practice
Godsey Lane
Market Deeping
PETERBOROUGH
PE6 8DD
Dear Patient
Patient requests for Occupational Hepatitis B vaccination (Hep B)
You have today requested a Hep B vaccination for occupational health reasons. Unfortunately GPs are not contracted to provide Hep B for occupational health purposes as part of their NHS responsibilities. In addition to this a GPs are not able to charge you as a registered patient for the administration of Hep B under their current contract arrangements.
Under Health and Safety legislation it is your employer who is responsible for undertaking an appropriate occupational health assessment and organising the necessary action. Once this has been carried out and your employer decides that you do require a Hep B we are happy to provide this service.
Step 1:Take the enclosed letter and request form to your employer for completion.
Step 2:You should complete the enclosed patient details form
Step 3:Return both of these completed forms to the following address:
Mrs Sue Goodale
Finance Assistant
The Deepings Practice
Godsey Lane
Market Deeping
PETERBOROUGH
PE6 8DD
On receipt of the completed paperwork we will raise an invoice accordingly. Once payment has been received in full you will be contacted to make an appointment for your course of vaccinations.
With kind regards
Yours sincerely
Mrs Jo Kevan
Business Manager
OCCUPATIONAL HEPATITIS B – PATIENT FORM
Patient name :
Patient date of birth:
Patient address:
Postcode:
Patient Contact telephone number:……………………………………………
Employers Name:
Employers full postal address:
Postcode:
For the attention of:…………………………………………………………….
Employers contact telephone number: …………………………………….
Please return completed form to:
Mrs Sue Goodale
Finance Assistant
The Deepings Practice
Godsey Lane
Market Deeping
Peterborough
PE6 8DD