Get My Employer Or Affiliated Health Facility, , Has Recommended - Immunize

This guide provides comprehensive instructions for filling out the My Employer Or Affiliated Health Facility, Has Recommended - Immunize form online. By following these steps, users can ensure they accurately represent their decision regarding influenza vaccination.

Follow the steps to complete the immunization declination form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of your employer or affiliated health facility in the designated field. Ensure that the name is spelled correctly as this identifies the institution you are associated with.
3. Read the provided information regarding the seriousness of influenza and the importance of vaccination. This section includes key facts about how influenza can affect both healthcare workers and patients.
4. In the space provided, clearly state your reasons for declining the vaccination. Be as specific as possible to communicate your decision effectively.
5. Please review the consequences outlined in the form regarding refusing the vaccination. It is important to understand the implications of your decision.
6. Once you have completed the form, provide your signature to confirm your understanding and choice regarding vaccination.
7. Insert the date of completion next to your signature to indicate when you made your declination.
8. Print or download the completed form if necessary. Ensure to keep a copy for your records and share it with your employer as required.

Take action now and complete your immunization declination form online.