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ENT (Title and Number) ISSUANCE DATE INFLUENZA VACCINATION EXEMPTIONS NAVHOSPPNCLAINST 6230.4C 15 Sep 2014 LOCAL FORM TITLE (Optional) INFLUENZA VACCINATION MEDICAL EXEMPTION REQUEST Confidentiality Statement: This document may contain information covered under the Privacy Act, 5 USC 552 (a), and/or the Health Insurance Portability and Accountability Act (PL 104-191) and its various implementing regulations and must be protected in accordance with those provisions. Healthcare information is.

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