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Immunization Health History Form All Students Must Complete Top Portion Name: LastFirstDate of Birth:Phone: (MI) Student ID Number: Month/Day/Year (TO BE COMPLETED BY NEW APPLICANTS ONLY) The General
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How to fill out immunization waiverrevised 111017docx
How to fill out immunization waiverrevised 111017docx
01
To fill out the immunization waiver, follow these steps:
02
Start by opening the immunization waiver form (revised 111017docx).
03
Read the instructions carefully to understand the requirements and purpose of the waiver.
04
Gather all the necessary information and supporting documents that may be required, such as medical records or doctor's notes.
05
Begin filling out the form by providing your personal information, including your full name, date of birth, and contact details.
06
Next, indicate the specific immunizations that you are seeking a waiver for.
07
Provide a brief explanation or reason for requesting the waiver. This could include medical contraindications, religious beliefs, or philosophical objections.
08
Review the completed form to ensure all sections are filled out accurately and completely.
09
If required, attach any supporting documents to the waiver form.
10
Sign and date the form, indicating your consent and understanding of the waiver.
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Submit the completed form to the relevant authority or organization as instructed.
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Keep a copy of the filled-out form and any supporting documents for your records.
Who needs immunization waiverrevised 111017docx?
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The immunization waiver (revised 111017docx) is typically needed by individuals who are seeking exemption from mandatory immunization requirements.
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This may include:
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- Individuals with documented medical contraindications, such as severe allergies or compromised immune systems.
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- Individuals with genuine religious beliefs that prohibit receiving immunizations.
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- Individuals with philosophical objections to immunization.
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It is important to note that specific requirements for obtaining the waiver may vary depending on local laws, regulations, and the organizations requiring immunization documentation.
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