Get the free Flu Declination Form - Extranet - University of Rochester
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University of Rochester Medical Center INFLUENZA VACCINE DECLINATION FORM 2012 2013 COMMUNITY PROVIDERS Complete form as follows and return by December 31, 2012: Section I: Vaccinated elsewhere (other
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What is flu declination form?
Flu declination form is a document that individuals can complete to decline receiving the flu vaccine.
Who is required to file flu declination form?
The flu declination form must be completed by individuals who choose not to receive the flu vaccine.
How to fill out flu declination form?
To fill out the flu declination form, you need to provide your personal details such as name, contact information, and reason for declining the vaccine.
What is the purpose of flu declination form?
The purpose of flu declination form is to document the decision of individuals who opt not to receive the flu vaccine.
What information must be reported on flu declination form?
The flu declination form typically requires personal information such as name, contact details, reason for declining the vaccine, and possibly any exemptions or alternatives being utilized.
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