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Employee PIN SADDLEBAGS VALLEY UNIFIED SCHOOL DISTRICT EMPLOYEE HEALTH INSURANCE PAYROLL DEDUCTION FORM EFFECTIVE 01/01/2016 Last Name (Please Print) First Name Certificated Classified Employees who
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How to fill out i am declining medical
How to fill out "I am declining medical":
01
Write your full name and contact information at the top of the form.
02
Read the instructions carefully to ensure you understand the implications of declining medical treatment.
03
Sign and date the form to indicate your decision to decline medical treatment.
04
Consider discussing your decision with a healthcare professional or a loved one before finalizing the form.
05
Make a copy of the completed form for your records.
Who needs "I am declining medical":
01
Individuals who are of sound mind and capable of making their own healthcare decisions.
02
Patients who have been fully informed about the risks and benefits of the medical treatment they are declining.
03
People who have made an informed decision after considering the advice and opinions of healthcare professionals.
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Those who have a clear understanding of the potential consequences of declining medical treatment.
05
Anyone who wishes to assert their right to refuse medical treatment for personal reasons, values, or beliefs.
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