Get the free UCSF Medical Center Influenza Vaccine Declination Form - research ucsf

This document serves as a declaration for individuals declining the influenza vaccine for the specified season, detailing the risks and responsibilities associated with this decision.

How to fill out ucsf medical center influenza

How to fill out UCSF Medical Center Influenza Vaccine Declination Form

1. Obtain the UCSF Medical Center Influenza Vaccine Declination Form from the official UCSF website or from your department.
2. Read the instructions carefully to understand the purpose of the form.
3. Complete the personal information section, including your name, department, and contact information.
4. Indicate your reason for declining the influenza vaccine by selecting an appropriate option provided on the form.
5. Review the form to ensure all information is accurate and complete.
6. Sign and date the form to acknowledge your understanding and acceptance of the declination.
7. Submit the completed form to your department's designated representative as instructed, making sure to keep a copy for your records.

Who needs UCSF Medical Center Influenza Vaccine Declination Form?

1. Employees of UCSF Medical Center who do not intend to receive the influenza vaccine during the flu season.
2. Individuals who are exempt from receiving the vaccine for medical, religious, or personal reasons.

People Also Ask about

Is it too late to get a flu vaccination?

It's never too late to get your vaccination, since influenza can circulate in the community all year round. The flu vaccine is recommended for everyone aged 6 months and over. It is free under the National Immunisation Program for people most at risk, including: children 6 months to less than 5 years.

What is a vaccine declination?

document the refusal of one or more recommended immunizations.

When is the flu season in UCSF?

Diagnosis. You may have the flu if you have a sudden onset of body aches, fever and respiratory symptoms, especially if your illness occurs between October and April – the usual flu season in the United States.

What do you put on a flu declination form?

I understand that the influenza vaccine cannot transmit influenza and it does not prevent all disease. I have declined to receive the influenza vaccine for the current flu season.

How late can a flu vaccine be given?

While earlier is generally better, you can get the flu shot later in the season — even into January or beyond. CDC states that it's fine to get vaccinated any time during flu season, provided unexpired vaccines are still available and flu viruses are still circulating.

How to decline a flu vaccine?

I have been given the opportunity to be vaccinated at no charge to me. However, I decline this vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Influenza Virus.

When is the flu shot deadline for UCSF?

For the current influenza season: You must have your flu shot and submit either documentation or submit a declination by November 1, 2024.

What is the latest date to get a flu shot?

The CDC recommends that people ages 6 months and older get a flu vaccine, ideally by the end of October. Even if you wait until after October, the vaccine will still be beneficial and provide protection. For more information on recommendations, visit this CDC page.

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What is UCSF Medical Center Influenza Vaccine Declination Form?

The UCSF Medical Center Influenza Vaccine Declination Form is a document that allows healthcare workers and employees to formally decline receiving the influenza vaccine, typically for personal, medical, or religious reasons.

Who is required to file UCSF Medical Center Influenza Vaccine Declination Form?

Employees and healthcare workers at UCSF Medical Center who choose not to receive the influenza vaccine due to personal, medical, or religious reasons are required to file this form.

How to fill out UCSF Medical Center Influenza Vaccine Declination Form?

To fill out the UCSF Medical Center Influenza Vaccine Declination Form, individuals must complete their personal details, indicate the reason for declination, and sign the form to confirm their choice.

What is the purpose of UCSF Medical Center Influenza Vaccine Declination Form?

The purpose of the UCSF Medical Center Influenza Vaccine Declination Form is to document the decision of healthcare workers and employees to decline the influenza vaccination and to ensure compliance with institutional policies regarding vaccination.

What information must be reported on UCSF Medical Center Influenza Vaccine Declination Form?

The information that must be reported on the UCSF Medical Center Influenza Vaccine Declination Form includes the individual's name, position, reasons for declination, and signature to acknowledge understanding of the implications of not receiving the vaccine.