Get Hpv Vaccine Refusal Form - District Of Columbia Public Schools

Filling out the HPV Vaccine Refusal Form is a straightforward process designed to ensure that your preferences regarding HPV vaccination are clearly communicated to the District of Columbia Public Schools. This guide will provide you with step-by-step instructions to complete the form efficiently and with confidence.

Follow the steps to successfully complete the HPV vaccine refusal form online.

1. Press the ‘Get Form’ button to access the HPV Vaccine Refusal Form. This action will allow you to download the document and open it for editing.
2. Begin by filling out Section 1, which requires you to enter the student information. Input the following details: 'Name of School', 'Student Name', 'Date of Birth', 'Grade', 'Street Address', 'City/State', 'Zip Code', and 'Phone'.
3. In the same section, include the 'Name and Address of Healthcare Provider', along with 'City/State', 'Zip Code', and 'Phone' of that provider.
4. Proceed to Section 2. Here, the parent or guardian, or the student (if 18 years of age or older), must read the HPV Information Statement regarding the benefits and implications of the vaccine.
5. Once the information has been reviewed, the authorized person must sign and date the form in the designated areas provided in Section 2.
6. Finally, after all sections are completed and reviewed, you can save your changes, and you will have options to download, print, or share the completed form as needed.

Complete your HPV Vaccine Refusal Form online today to ensure the health and safety of your student.