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Get Varicella Declination Form
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How to fill out the Varicella Declination Form online
Filling out the Varicella Declination Form online is a straightforward process that helps ensure that individuals are informed about the risks of varicella zoster virus and their vaccination options. This guide provides step-by-step instructions to assist users in completing the form accurately and effectively.
Follow the steps to fill out the Varicella Declination Form online.
- Press the ‘Get Form’ button to access the form and open it in the online system.
- Read the introductory information carefully, including the risks associated with varicella zoster virus and vaccination recommendations. This section provides vital context for your decision-making.
- Indicate your decision regarding the varicella vaccine by selecting one of the provided options: either to participate in the vaccination program or to decline it.
- If applicable, list the dates of any prior varicella vaccinations in the designated section.
- Enter your personal information. This includes your full name, phone number, UCSD employee ID number, email address, department name, and department recharge index number for tracking.
- Specify the principal investigator you work for, if necessary, along with your participant status by checking all applicable categories provided.
- Provide your signature to confirm the accuracy of the information provided and the decision regarding the vaccine. Also, include the date of signing.
- Once you have filled in all required fields, save your changes. You can choose to download, print, or share the completed form as needed.
Complete the Varicella Declination Form online today to ensure your health and safety regarding varicella vaccination options.
Precautions for Varicella Vaccination People with acute severe illness, including untreated, active tuberculosis, should postpone vaccination until they recover. The decision to delay vaccination depends on the severity of symptoms and the etiology of disease.
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