Get the free Health Services Employee Influenza Immunization Declination Form - scdhec
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This form is intended for documenting the refusal of influenza vaccination by DHEC Health Services employees, outlining their understanding of associated risks and procedures for declination.
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How to fill out health services employee influenza
How to fill out Health Services Employee Influenza Immunization Declination Form
01
Obtain the Health Services Employee Influenza Immunization Declination Form from your employer or health department.
02
Read the form carefully to understand the reasons for declination and the information required.
03
Fill in your personal information including your name, position, and department.
04
Check the appropriate box to indicate your reason for declining the flu vaccination.
05
Sign and date the form to confirm your understanding of the consequences of not receiving the vaccine.
06
Submit the completed form to your supervisor or designated health services personnel as instructed.
Who needs Health Services Employee Influenza Immunization Declination Form?
01
Employees who are eligible for the influenza vaccination but choose not to receive it.
02
Staff members in healthcare settings where influenza vaccinations are recommended or required.
03
Individuals who must formally document their declination for record-keeping or compliance purposes.
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People Also Ask about
Should I decline the flu vaccine?
The U.S. Centers for Disease Control and Prevention recommends yearly seasonal influenza vaccinations for everyone age 6 months or older who doesn't have a medical reason to avoid the vaccine.
What is the religious reason for not getting the flu shot?
Objection to vaccination was also related to: faith in divine protection and healing for Protestants, Catholics, Jewish and Muslims (10); the use of aborted fetal cells for vaccines' production among Amish and Catholic communities (including during the COVID-19 outbreak when Senior Catholic leaders from the US and
Is the influenza vaccine mandatory?
Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. Flu vaccination has important benefits.
What do you put on a flu declination form?
I DO NOT WANT A FLU SHOT. I acknowledge that I am aware of the following facts: Influenza is a serious respiratory disease; on average, 36,000 Americans die every year from influenza-related causes, Influenza virus may be shed for up to 24 hours before symptoms begin, increasing the risk of transmission to others.
How to politely decline a flu shot?
Despite these facts, I have decided to decline the influenza vaccine by my signature below. I realize that I may re-address this issue at any time and accept vaccination in the future.
How to decline vaccines?
Talk to their doctor or read about the benefits of vaccines and the risks of not vaccinating their children. Get a signature from a local health department official. Write a letter that explains their reasons for refusing vaccines.
What to say to decline the flu vaccine?
I acknowledge that I have read this document in its entirety and fully understand it. Despite these facts, I have decided to decline the influenza vaccine by my signature below. I realize that I may re-address this issue at any time and accept vaccination in the future.
What is a vaccine declination?
document the refusal of one or more recommended immunizations.
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What is Health Services Employee Influenza Immunization Declination Form?
The Health Services Employee Influenza Immunization Declination Form is a document that employees can use to formally decline the influenza vaccination offered by their employer's health services.
Who is required to file Health Services Employee Influenza Immunization Declination Form?
Employees who choose not to receive the influenza vaccination, despite being offered the opportunity, are required to file the Health Services Employee Influenza Immunization Declination Form.
How to fill out Health Services Employee Influenza Immunization Declination Form?
To fill out the form, employees should provide their personal information, including name, position, department, and the reason for declining the vaccine, and then sign and date the form.
What is the purpose of Health Services Employee Influenza Immunization Declination Form?
The purpose of the form is to document that an employee has chosen to decline the influenza vaccination, ensuring that the employer maintains accurate records and complies with health regulations.
What information must be reported on Health Services Employee Influenza Immunization Declination Form?
The form must report the employee's name, job title, department, date, signature, and a clear indication of the reason for declination.
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