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Southern California . Tetanus, Diphtheria & Pertussis (Tdap) Declination Form. Print Name: I acknowledge that I am aware of the following .

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How to fill out the Tdap Declination Form online

Filling out the Tdap Declination Form is a straightforward process that helps individuals formally acknowledge their decision regarding the Tdap vaccination. This guide provides clear instructions to assist users in completing the form online.

Follow the steps to complete the Tdap Declination Form online.

  1. Click the ‘Get Form’ button to obtain the form and open it in the relevant online editor.
  2. In the 'Print Name' field, fill in your full name as you would like it to appear on the form.
  3. Read the acknowledgment section carefully to understand the information about pertussis and the risks associated with declining the vaccine.
  4. After reviewing, sign your name in the designated 'Signature' field to indicate your acknowledgment of the stated facts.
  5. Enter the current date in the 'Date' field; this should reflect the date you are submitting the form.
  6. Once all fields are filled out, review the information for accuracy before proceeding.
  7. You can then save changes, download, print, or share the completed form as needed, following the prompts in the online editor.

Begin completing your Tdap Declination Form online today for a seamless process.

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Should I get a Tdap shot? Yes. All pregnant women should get a Tdap shot in the third trimester, preferably between 27 weeks and 36 weeks of pregnancy. The Tdap shot is an effective and safe way to protect you and your baby from serious illness and complications of pertussis.

Vaccine Education Center Diphtheria, tetanus and pertussis are prevented by a childhood vaccine, called DTaP, and a vaccine for adolescents and adults, called Tdap. A version for adults is also available without the pertussis component, called Td.

Experts do not know what level of whooping cough antibodies is needed to protect anyone, including babies, from getting sick. That is why CDC recommends all women get Tdap during each pregnancy — even women with some antibodies due to a previous infection or vaccination.

Many pregnant women refuse the Tdap and influenza vaccines23 for a variety of reasons,24 including common misperceptions (“It will make me sick”), concerns for the safety of the fetus or neonate, and personal health beliefs (“I never get the flu shot”).

All pregnant women should get the Tdap vaccine during each pregnancy. The vaccine helps your body make antibodies to protect you from disease. These antibodies pass to your fetus and can protect your newborn until he or she can get the Tdap vaccine at 2 months old.

It can lead to breathing problems, paralysis, and heart failure. Even with treatment, about 1 out of 10 people with diphtheria die. PERTUSSIS (whooping cough) causes severe coughing spells that can cause breathing difficulty.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232