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Medical Exemption for Influenza Vaccine Application 20172018 Employee Instructions/ Complete the following information Name (last, first) Duke Unique ID Work Area Best Phone Number Email Address:

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What is medical exemption for influenza?

Medical exemption for influenza is a document that allows individuals to be excused from receiving the influenza vaccine for medical reasons.

Who is required to file medical exemption for influenza?

Individuals who have a specific medical condition that prevents them from receiving the influenza vaccine are required to file a medical exemption.

How to fill out medical exemption for influenza?

To fill out a medical exemption for influenza, individuals must provide necessary medical documentation and information about their condition, signed by a healthcare provider.

What is the purpose of medical exemption for influenza?

The purpose of a medical exemption for influenza is to protect the health of individuals who are unable to receive the influenza vaccine due to medical reasons.

What information must be reported on medical exemption for influenza?

Information such as the individual's name, medical condition, healthcare provider's signature, and the reason for the exemption must be reported on the medical exemption for influenza.

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