Get Signed Declination Form - Providence Washington

This guide provides clear instructions for completing the Signed Declination Form - Providence Washington. By following these steps, users can effectively fill out the form online and ensure that their declination is properly documented.

Follow the steps to fill out the Signed Declination Form online

1. Press the ‘Get Form’ button to access the form and open it in your chosen document editor.
2. Begin by entering your name in the designated field at the top of the form. Ensure that it is spelled correctly to avoid any processing delays.
3. Next, provide your date of birth in the appropriate field. This helps to identify you uniquely.
4. Fill in your department and position within the organization, ensuring accuracy as this information verifies your role.
5. If you have already received the Seasonal Influenza vaccine, indicate where you received it and the date of vaccination in the specified fields.
6. In the acknowledgment section, please read the provided statements carefully. This section outlines the importance of influenza vaccination and its implications for your role.
7. Choose one reason for your declination by marking the corresponding box: medical, religious objection, or other. If you select 'other,' please specify your reason in the provided space.
8. Sign the form in the designated area to confirm your declination and understanding of the information provided. Include the date of your signature.
9. Finally, review all the information you have entered for accuracy. Once confirmed, you can save the changes, download, print, or share the completed form as needed.

Complete your document online today to ensure your declination is properly recorded.