Get Hepatitis B Vaccination Acceptance Or Declination Form - Losrios

Completing the Hepatitis B Vaccination Acceptance or Declination Form is an important step for eligible employees of Losrios. This guide provides you with clear and thorough instructions on how to fill out the form online, ensuring that you understand each section.

Follow the steps to complete the Hepatitis B vaccination form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill out the ‘Employee Information’ section with your details including your name, employee ID number, job title, supervisor name, department name, and employee type.
3. If you have already received the Hepatitis B vaccination, complete the ‘Vaccination Received’ section by entering the approximate date of vaccination and the name of the doctor’s office where you received it.
4. If you have not received the vaccination, select either the ‘Acceptance’ or ‘Statement of Non-participation’ section depending on your choice regarding the vaccination.
5. In the ‘Acceptance’ section, confirm that you have received information and training about Hepatitis B and consent to receive the vaccine. Provide your signature and the date.
6. In the ‘Declination’ section, acknowledge your understanding of the risks and your decision to decline the vaccine. Again, provide your signature and the date.
7. Once all sections have been completed accurately, forward the form to the District Office Human Resources Department.
8. You may save your changes, download a copy of the form, print it out, or share it as needed.

Take action now and complete your Hepatitis B Vaccination Acceptance or Declination Form online.