Get Pws Flu Declination Form 2014-2015

This guide provides users with clear instructions on how to complete the PWS Flu Declination Form for the 2014-2015 season online. By following the steps outlined below, users can easily navigate the form and ensure they provide all necessary information accurately.

Follow the steps to fill out the PWS Flu Declination Form online

1. Press the ‘Get Form’ button to access the form and open it in your online editor.
2. In the first field, enter your name as it should appear printed.
3. Next, provide your 3-4 ID number in the designated section to verify your identity.
4. Indicate your employer by filling out the relevant space with the organization's name.
5. Select the declination type by checking one of the boxes provided: Parallon Employee, Agency Employee or Contractor, or Dependent Healthcare Professional.
6. Read the statement regarding the recommendation for influenza vaccination and acknowledge your decision to decline the flu shot.
7. Review the facts about influenza provided on the form to ensure you understand the implications of declining the vaccination.
8. Select the reason for your declination from the available options listed on the form.
9. Sign the form in the designated area to confirm your decision and understand the consequences.
10. Finally, date the form appropriately to document your declination.
11. Once completed, save your changes, download the form, print it for your records, or share it as needed.

Complete your PWS Flu Declination Form online today to ensure your preferences are documented.