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Month:Days 1–15 (16-31 continued on other side)
Instructions for Temperature Log:Check both temperatures twice a day, each working day of the month. Placean "X" in the boxes that show the temperatures you read in the morning andafternoon; enter your initials and the time in the boxes at the top of the day’scolumn. If your entry is in a shaded area, take immediate action! Use a newform each month and save in a file at month’s end for one year.
*TAKE IMMEDIATE ACTION if the temperatureis too high or too low:1. Store the vaccine under proper conditions as quickly as possible.
2. Call your VFC Representative.
3. If he/she is not available, call VFC Customer Service at 1-877-2GET-VFC (1-877-243-8832)
Check Both Temperatures Twice A DayRefrigerator
Staff Initials
Day of Month
Time
≥ 49ºF
48ºF
47ºF
46ºF
45ºF
44ºF
43ºF
42ºF
41ºF
40ºF39ºF
38ºF
37ºF
36ºF
35ºF
34ºF
33ºF
≤ 32ºF
1
am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm
2 3 4 5 6 7 9 10 11 12 13 14 158
Freezer≥ 8ºF
7ºF
6ºF
5ºF
4ºF
≤ 3ºF
VFC Field Representative LHD Immunization Program
Vaccines for Children ProgramCalifornia Department of Health Services850 Marina Bay Parkway Richmond, CA 94804IMM-682 Fahrenheit (Fº) Temperature Log (3/06)
( ) ( )
Too h
igh
*To
o h
igh
*To
o l
ow
*
Aim for
Fº
Take immediate action* if temperature is in the shaded area.
If temperature is above 49º F, write in the current temperature.
If temperature is below 32º F, write in the current temperature.
Take immediate action* if temperature is in the shaded area.
Take immediate action* if temperature is in the shaded area.
If temperature is above 8º F, write in the current temperature.
*TAKE IMMEDIATE ACTION if thetemperature is too high or too low:
1. Store the vaccine under proper conditions as quickly as possible.2. Call the VFC Contact Center
Check both temperatures twice a day, each working day of the month. Placean "X" in the boxes that show the temperatures you read in the morning andafternoon; enter your initials and the time in the boxes at the top of the day’scolumn. If your entry is in a shaded area, take immediate action! Use a newform each month and save in a file at month’s end for one year.
Adapted by the MD Center for Immunization courtesy of the California Department of Health Services.
Vaccines for Children ProgramMaryland Department of Health & Mental [email protected]
Temperature Log (4/11)
Too h
igh
*To
o l
ow
*To
o h
igh
*Month:Days 16–31 (1-15 on other side)
am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm pmam
31302928272625242322212019181716
Refrigerator
Staff Initials
Day of Month
Time
≥ 49ºF
48ºF
47ºF
46ºF
45ºF
44ºF
43ºF
42ºF
41ºF
40ºF39ºF
38ºF
37ºF
36ºF
35ºF
34ºF
33ºF
≤ 32ºF
Freezer≥ 8ºF
7ºF
6ºF
5ºF
4ºF
≤ 3ºF
Instructions for Temperature Log:Check both temperatures twice a day, each working day of the month. Placean "X" in the boxes that show the temperatures you read in the morning andafternoon; enter your initials and the time in the boxes at the top of the day’scolumn. If your entry is in a shaded area, take immediate action! Use a newform each month and save in a file at month’s end for one year.
*TAKE IMMEDIATE ACTION if the temperatureis too high or too low:1. Store the vaccine under proper conditions as quickly as possible.
2. Call your VFC Representative.
3. If he/she is not available, call VFC Customer Service at 1-877-2GET-VFC (1-877-243-8832)
VFC Field Representative LHD Immunization Program
Vaccines for Children ProgramCalifornia Department of Health Services850 Marina Bay Parkway Richmond, CA 94804IMM-682 Fahrenheit (Fº) Temperature Log (3/06)
( ) ( )
Check Both Temperatures Twice A DayFº
Aim for
Take immediate action* if temperature is in the shaded area.
If temperature is above 49º F, write in the current temperature.
If temperature is below 32º F, write in the current temperature.
Take immediate action* if temperature is in the shaded area.
Take immediate action* if temperature is in the shaded area.
If temperature is above 8º F, write in the current temperature.
*TAKE IMMEDIATE ACTION if thetemperature is too high or too low:
1. Store the vaccine under proper conditions as quickly as possible.2. Call the VFC Contact Center
Check both temperatures twice a day, each working day of the month. Placean "X" in the boxes that show the temperatures you read in the morning andafternoon; enter your initials and the time in the boxes at the top of the day’scolumn. If your entry is in a shaded area, take immediate action! Use a newform each month and save in a file at month’s end for one year.
Adapted by the MD Center for Immunization courtesy of the California Department of Health Services.
Vaccines for Children ProgramMaryland Department of Health & Mental [email protected]
Temperature Log (4/11)
