Vaccine Temperature Log

• Clinic/ Hospital

• Conducted on

  Date

• Prepared by

• Location
  Address

Vaccine Storage Temperature

• Refrigerator/ Freezer

  Select Refrigerator Freezer

  • Refrigerator
  • Freezer

• + Refrigerator Temperature Reading

Refrigerator Temperature Temperature:

• If refrigerator temperature is not between 35°F and 46°F, note the vaccine and inform your superior.

• Vaccine name:

• Action taken:

• Photo (optional):

  Media

• Name and signature of inspector

  Sign

• + Freezer Temperature Reading

Freezer Temperature Temperature:

• If freezer temperature is not between -58°F and 5°F, note the vaccine and inform your superior.

• Vaccine name:

• Action taken:

• Photo (optional):

  Media

• Name and signature of inspector

  Sign