Vaccination laws are very state specific. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
The Wisconsin Modified American Academy of Pediatrics (AAP) Refusal of Vaccination Form is a crucial document that helps parents or guardians in the state of Wisconsin with their decision to decline vaccinations for their children. Designed by the American Academy of Pediatrics and modified specifically for use in Wisconsin, this form ensures that parents understand the risks associated with refusing vaccines while acknowledging their decision and assuming responsibility for any consequences. The Wisconsin Modified AAP Refusal of Vaccination Form provides space for parents or guardians to fill in essential information, such as their child's name, date of birth, and the specific vaccines they decline. This allows healthcare providers to keep accurate records and have a clear understanding of which vaccinations are being refused. The form may include options to refuse individual vaccines, combinations of vaccines, or all recommended immunizations. Key sections within this legally binding document include: 1. Parent/Guardian Information: Names, addresses, phone numbers, and signatures of parents or guardians are required to ensure their informed consent and commitment to the decision. 2. Child Information: This section captures the child's name, birthdate, and other relevant details to avoid any confusion about the intended recipient of the vaccination refusal. 3. Acknowledgment of Information: Parents must acknowledge that they have received and understood the most recent vaccine information statements, as provided by the Centers for Disease Control and Prevention (CDC), which outline the benefits and potential risks associated with each vaccine. 4. Acknowledgment of Consequences: By signing this form, parents accept responsibility for their decision and acknowledge the risks their child may face due to vaccine-preventable diseases. It clarifies that the child may be excluded from school or child care during any outbreak or expose others to illness. Different versions of the Wisconsin Modified AAP Refusal of Vaccination Form may exist to cater to specific circumstances or healthcare providers' preferences. These variations could include different formatting, sections for additional information, or variations in wording while maintaining the central objective of enabling parents to refuse vaccines while acknowledging the associated risks. In conclusion, the Wisconsin Modified American Academy of Pediatrics Refusal of Vaccination Form is an essential tool that empowers parents or guardians in Wisconsin to openly decline vaccinations for their children. This standardized document ensures that parents are well-informed and reinforces the importance of understanding the associated responsibilities and potential consequences.
