Declination Of Flu Vaccine Form

Declination Of Flu Vaccine Form - I understand that it is impossible to get influenza from influenza vaccine. I have read and understand the information provided in this informed refusal. I have had the full opportunity to. I understand that if i choose to decline the influenza vaccine, i will be required to wear a surgical mask or respirator beginning november 1, during all. The consequences of my refusal to be vaccinated could have life. Despite these facts, i have decided to decline the influenza vaccine by my signature below. By signing this form, i acknowledge that:

The consequences of my refusal to be vaccinated could have life. I understand that if i choose to decline the influenza vaccine, i will be required to wear a surgical mask or respirator beginning november 1, during all. I have read and understand the information provided in this informed refusal. Despite these facts, i have decided to decline the influenza vaccine by my signature below. I have had the full opportunity to. By signing this form, i acknowledge that: I understand that it is impossible to get influenza from influenza vaccine.

I have read and understand the information provided in this informed refusal. I understand that it is impossible to get influenza from influenza vaccine. The consequences of my refusal to be vaccinated could have life. By signing this form, i acknowledge that: I understand that if i choose to decline the influenza vaccine, i will be required to wear a surgical mask or respirator beginning november 1, during all. I have had the full opportunity to. Despite these facts, i have decided to decline the influenza vaccine by my signature below.

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I Have Had The Full Opportunity To.

By signing this form, i acknowledge that: I understand that if i choose to decline the influenza vaccine, i will be required to wear a surgical mask or respirator beginning november 1, during all. I understand that it is impossible to get influenza from influenza vaccine. The consequences of my refusal to be vaccinated could have life.

I Have Read And Understand The Information Provided In This Informed Refusal.

Despite these facts, i have decided to decline the influenza vaccine by my signature below.

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