Get Stanford University Hepatitis B Vaccine Declaration Form 2016-2025

Filling out the Stanford University Hepatitis B Vaccine Declaration Form online is a crucial step for individuals working in environments with a potential risk of hepatitis B exposure. This guide provides detailed instructions on how to complete each section of the form easily and efficiently.

Follow the steps to complete the form accurately

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name in the designated field. Ensure that you provide your full legal name as required.
3. Next, input your Stanford University Student ID, which consists of 8 digits. This number is essential for properly identifying your record.
4. Provide your email address in the corresponding field to facilitate communication regarding your vaccination status.
5. Enter your daytime or work phone number. This information is vital for scheduling or discussing vaccination appointments.
6. Specify your job title and the department you are affiliated with. This helps clarify your role within the university.
7. Identify your supervisor or Principal Investigator by entering their name in the appropriate section. This confirms accountability regarding vaccination eligibility.
8. Choose your Stanford work location by checking all applicable boxes, ensuring your role is correctly represented.
9. Select your employment status from the options provided, as this affects your eligibility for free vaccinations.
10. In the next section, have your supervisor complete the confirmation regarding your eligibility for vaccination, signing and dating where indicated.
11. Complete one of the available sections where you indicate either your request to receive the hepatitis B vaccine series or your declination to receive the vaccine. Be sure to sign and date this part.
12. Finally, review all your entries for accuracy, then save your changes. You can choose to download a copy for your records, print the form, or share it as instructed.

Start filling out the Stanford University Hepatitis B Vaccine Declaration Form online today to ensure your health and safety.