Perinatal Hepatitis B Sample Letter: Serology Test Completed
_________________
__________________
__________________
__________________
Dear Mrs. or Ms. ______________:
Congratulations, your baby is fully protected from hepatitis B. Your baby got all the needed injections and the follow-up blood test. You do not need to take any other actions for your baby.
Also, this letter is to encourage your other family and household members to get tested for hepatitis B, and, if needed, to get their injections at their doctor’s office or at ______________________.
If you have another pregnancy, I will contact you again because mothers who carry hepatitis B can pass it on to their babies at birth.
Please keep this letter with a record of your baby’s hepatitis B injections.
Baby’s name:
Birth date:
Birthing facility:
Baby’s doctor:
Date HBIG and HBV#1 given:
Date HBV#2 given:
Date HBV#3 given:
Date tested and results:
If you have any questions, please call me at _________________.
Sincerely,
Perinatal Hepatitis B Coordinator
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