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HEPATITIS B VACCINATION DECLINATION FORM I, have read the Vaccine Information Statement: Hepatitis B Vaccine: What You Need to Know published by the Centers for Disease Control and Prevention and
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How to fill out h b vaccination declination
How to fill out h b vaccination declination
01
Obtain the h b vaccination declination form from a healthcare provider.
02
Read and understand the information provided on the form regarding the risks and benefits of h b vaccination.
03
Fill out your personal information accurately, including your name, date of birth, and contact information.
04
Check the appropriate box to indicate your decision to decline h b vaccination.
05
Sign and date the form at the designated area to indicate your understanding and acceptance of the potential consequences of declining h b vaccination.
06
Return the completed form to the healthcare provider or submit it as instructed.
Who needs h b vaccination declination?
01
Anyone who has received h b vaccination or is considering h b vaccination should be familiar with the h b vaccination declination form.
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