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20152016 INFLUENZA VACCINATION DECLINATION FORM St. Vincent's Health Services and the CDC have recommended that I receive influenza vaccination in order to protect myself, my family, my colleagues
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How to fill out flu declination form
How to fill out a flu declination form:
01
Read the form carefully: Begin by thoroughly reading the flu declination form to understand the information being asked for and any specific instructions provided.
02
Provide personal information: Fill in your personal details as required on the form. This may include your full name, date of birth, employee/identification number, and contact information.
03
Reason for declination: If the form asks for the reason why you are choosing to decline the flu vaccine, provide an explanation. This may include medical reasons, personal beliefs, or other valid justifications.
04
Date and signature: Sign and date the form to confirm your declination. Make sure to follow any additional instructions regarding witnesses or additional signatures, if applicable.
05
Submit the form: Once you have completed filling out the form, follow the instructions provided to submit it. This may involve handing it over to a supervisor, mailing it to a specific address, or submitting it electronically.
Who needs a flu declination form?
01
Employees with valid medical reasons: Individuals who have medical conditions or circumstances that prevent them from receiving the flu vaccine may need a flu declination form. These forms provide documentation of their exemption from the vaccine requirement.
02
Individuals with religious or personal beliefs: Some individuals may have religious or personal beliefs that prevent them from receiving vaccines. These individuals may be required to fill out a flu declination form to formally state their reasons for refusing the flu vaccine.
03
People who choose alternative preventative measures: In some cases, individuals may choose alternative methods for preventing the flu, such as natural remedies or lifestyle changes. If the organization or institution requires documentation of such decisions, a flu declination form may be necessary.
It is important to note that the specific requirements for a flu declination form may vary depending on the organization, institution, or jurisdiction. It is recommended to consult the guidelines provided by the relevant authority for accurate information on the process and eligibility criteria for filling out the flu declination form.
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