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VARICELLA IMMUNIZATION PERMISSION/REFUSAL FORM Student's Last Name Student's First Name Room/Section I have been given a copy and have read (or have had explained to me) the information in the Varicella

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What is varicella immunization permissionrefusal form?

The varicella immunization permission/refusal form is a document that allows parents or guardians to provide consent or refuse to have their child receive the varicella (chickenpox) vaccine.

Who is required to file varicella immunization permissionrefusal form?

Parents or guardians of children who are subject to varicella immunization requirements are required to file the varicella immunization permission/refusal form.

How to fill out varicella immunization permissionrefusal form?

To fill out the varicella immunization permission/refusal form, parents or guardians need to provide their child's personal information, indicate whether they give consent or refuse vaccination, and sign the form.

What is the purpose of varicella immunization permissionrefusal form?

The purpose of the varicella immunization permission/refusal form is to provide parents or guardians with the opportunity to give their consent or refusal for their child to receive the varicella vaccine, in accordance with immunization requirements.

What information must be reported on varicella immunization permissionrefusal form?

The varicella immunization permission/refusal form requires parents or guardians to report their child's personal information, such as full name, date of birth, and contact details. They must also indicate whether they give consent or refuse vaccination.

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