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HEPATITIS B VACCINE DECLINATION/ACCEPTANCE FORM MANDATORY Name: Date: Dept. name: Start date: In accordance with OSHA standards, I understand that due to my occupational exposure to blood or other

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How to fill out hepatitis b vaccine declinationacceptance

01

To fill out the hepatitis B vaccine declination/acceptance form, follow these steps:

02

Obtain a copy of the form from your healthcare provider or employer.

03

Read the instructions and information provided on the form carefully.

04

Fill in your personal details, including your full name, date of birth, and contact information.

05

Check the appropriate box indicating whether you are accepting or declining the hepatitis B vaccine.

06

If declining, provide a valid reason for your decision.

07

Sign and date the form.

08

Submit the completed form to your healthcare provider or employer as instructed.

09

Keep a copy of the form for your records.

Who needs hepatitis b vaccine declinationacceptance?

01

Hepatitis B vaccine declination/acceptance form is required for individuals who have been offered the hepatitis B vaccine but choose to decline it.

02

This form is commonly used in healthcare settings, workplaces, educational institutions, and other settings where the hepatitis B vaccine is recommended or required.

03

It is important for individuals to consult with their healthcare provider or follow the guidelines provided by their employer or institution to determine if they need to fill out the hepatitis B vaccine declination/acceptance form.

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