Get Save Form Print Form Submit Form Georgetown University Office Of Environmental Health And Safety

Filling out the SAVE FORM PRINT FORM SUBMIT FORM for Georgetown University's Office of Environmental Health and Safety is an essential step for individuals considering the Hepatitis B vaccine. This guide provides a straightforward approach to assist you in completing the form correctly and efficiently.

Follow the steps to complete the Hepatitis B Vaccination Acceptance or Declination Form.

1. Press the ‘Get Form’ button to obtain the form, which will open in your online editor.
2. Begin by filling out the employee information section. Include your name, job title, building/lab number, department, and your supervisor's name along with their phone number.
3. Indicate your decision regarding the Hepatitis B vaccination. You must select either the ‘Acceptance’ or ‘Declination’ section by marking the corresponding checkbox.
4. If you choose ‘Acceptance’, you will need to contact Simona Diggs, the Occupational Health Coordinator, at extension 7-1734 to schedule your vaccination series, which consists of three doses.
5. If you opt for ‘Declination’, check one of the applicable reasons provided for your decision, indicating if you have previously completed the vaccination series or if you choose not to receive it at this time.
6. Sign and date the form at the bottom. Ensure your signature confirms that you have received the necessary information and training regarding the Hepatitis B vaccine.
7. After completing the form, ensure you save your changes. You can then download, print, or share the form as needed.

Complete your form online today to ensure your health and compliance with workplace safety requirements.