Get Vaccine Declination Form

This guide provides clear and concise instructions on how to complete the Vaccine Declination Form online. By following these steps, users can easily navigate the form to ensure their submission is accurate and complete.

Follow the steps to complete the Vaccine Declination Form online

1. Press the ‘Get Form’ button to access the Vaccine Declination Form and open it in your preferred editor.
2. Begin by entering your personal information in the designated fields. Include your full name, date of birth, title or position, department, supervisor’s name, and personal phone number.
3. Identify your employment status by circling the appropriate option. Possible options include employee, contractual, volunteer, agency, and others.
4. In the section titled 'Declination of Annual Influenza Vaccination,' read the statements carefully to understand the implications of declining the vaccine.
5. Indicate your reason(s) for declining the vaccination by checking all applicable boxes provided.
6. If you received the vaccine from another facility, provide documentation as specified. If requesting a medical exception or religious accommodation, ensure the appropriate forms are completed and submitted.
7. Complete the signature section. Sign and date the form to attest to the information provided.
8. Finally, review all entered information for accuracy, and then save your changes. You can download, print, or share the completed form as needed.

Complete your Vaccine Declination Form online today to ensure a smooth process.