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Medical Exemption for Influenza Vaccine Application 20182019 Employee Instructions/ Complete the following information Name (last, first) Duke Unique ID Work Area Best Phone Number Email Address:
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How to fill out influenza med exemption app2018-19docx
How to fill out influenza med exemption app2018-19docx
01
To fill out the influenza med exemption app2018-19docx, follow these steps:
02
Open the influenza med exemption app2018-19docx on your computer.
03
Read the instructions and requirements carefully.
04
Provide your personal information such as name, date of birth, and contact details.
05
Fill in the medical information accurately. Include any relevant medical conditions or allergies.
06
Provide the reason for requesting exemption from the influenza medication.
07
Review the completed form for any errors or omissions.
08
Save the filled-out form to your computer or print it out.
09
Submit the form as per the specified instructions or hand it to the relevant authority.
Who needs influenza med exemption app2018-19docx?
01
Individuals who are seeking exemption from influenza medication should fill out the influenza med exemption app2018-19docx. This may include individuals with certain medical conditions, allergies, or other valid reasons for not being able to receive the influenza vaccine.
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What is influenza med exemption app2018-19docx?
It is a document used to request exemption from receiving the influenza vaccination for the 2018-19 season.
Who is required to file influenza med exemption app2018-19docx?
Individuals who are unable to receive the influenza vaccination for medical reasons are required to file this exemption form.
How to fill out influenza med exemption app2018-19docx?
The form must be completed with the individual's personal information, medical reasons for exemption, and signed by a healthcare provider.
What is the purpose of influenza med exemption app2018-19docx?
The purpose is to provide a way for individuals with medical reasons to be exempt from receiving the influenza vaccination.
What information must be reported on influenza med exemption app2018-19docx?
Personal information, medical reasons for exemption, and healthcare provider's signature.
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