Get the free Flu attestation/declination form - ohsu

2014-2015 Influenza Vaccination Attestation/Declination Form OSU recommends I receive influenza vaccination to protect the patients OSU serves. I attest that I have already received the influenza

How to fill out flu attestationdeclination form

How to fill out flu attestation/declination form:

1. Begin by reading the instructions carefully: Before filling out the form, make sure you understand the purpose and requirements of the flu attestation/declination form. Familiarize yourself with any specific guidelines or instructions provided.
2. Provide your personal information: Start by entering your full name, date of birth, and any other requested personal details. Make sure to fill in all the required fields accurately.
3. Indicate your decision: The form will typically ask you to indicate whether you are attesting that you have received the flu vaccine or if you are declining it. Select the appropriate option based on your decision.
4. Date and sign the form: After indicating your decision, you may be required to provide the date and sign the form to validate your response. Ensure that you provide the current date and sign the form with your legal signature.
5. Submit the form: Once you have completed filling out the form, check for any errors or missing information. Double-check that you have signed and dated the form. Follow the instructions on where and how to submit the form. It may need to be returned to a specific department or individual, or it could be submitted electronically.

Who needs flu attestation/declination form:

1. Healthcare professionals: In many medical settings, healthcare professionals are required to either receive a flu vaccination or fill out a flu attestation/declination form. This ensures that the workplace is taking appropriate measures to protect patients and staff from the flu virus.
2. Educational institutions: Some schools and universities may require students, teachers, and staff to either get the flu vaccine or submit a flu attestation/declination form. This helps prevent the spread of the flu within the educational setting.
3. Workplaces: Certain workplaces, especially those where close contact with individuals is common, may implement flu vaccination policies. Employees may be required to provide proof of vaccination or fill out a flu attestation/declination form to ensure a safe work environment.

Note: The specific individuals or organizations that require a flu attestation/declination form may vary depending on local regulations, industry practices, and organizational policies. It is essential to consult the relevant authorities or guidelines to determine who needs to fill out such a form in your specific context.

For pdfFiller’s FAQs

What is flu attestationdeclination form?

Flu attestationdeclination form is a document used to report whether an individual has received a flu vaccine or has declined to receive it.

Who is required to file flu attestationdeclination form?

Employees in certain industries or healthcare settings may be required to file flu attestationdeclination form.

How to fill out flu attestationdeclination form?

Flu attestationdeclination form can typically be filled out online or in person by providing your personal information and indicating whether you have received the flu vaccine or declined it.

What is the purpose of flu attestationdeclination form?

The purpose of flu attestationdeclination form is to track the flu vaccination statuses of individuals in order to prevent the spread of flu and protect public health.

What information must be reported on flu attestationdeclination form?

The information reported on flu attestationdeclination form typically includes personal details, vaccination status, and any reasons for declining the flu vaccine.

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