Get the free Influenza Vaccination Declination Form NSW Health

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NSW HealthInfluenza Vaccination Declination Form Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases Policy Directive I, (full name) declare that: I understand

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How to fill out influenza vaccination declination form

01

Obtain the influenza vaccination declination form from your employer or healthcare provider.

02

Fill out your personal information such as name, date of birth, and contact information on the form.

03

Indicate the reason for declining the influenza vaccination on the form.

04

Sign and date the form to acknowledge that you are declining the vaccination.

Who needs influenza vaccination declination form?

01

Individuals who are unable or unwilling to receive the influenza vaccination for medical, religious, or personal reasons may need to fill out an influenza vaccination declination form.

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What is influenza vaccination declination form?

The influenza vaccination declination form is a document that allows individuals to indicate their decision not to receive the influenza vaccine.

Who is required to file influenza vaccination declination form?

Individuals who are mandated to receive the influenza vaccine but choose to decline it are required to file the influenza vaccination declination form.

How to fill out influenza vaccination declination form?

To fill out the influenza vaccination declination form, individuals typically need to provide their name, contact information, reason for declining the vaccination, and signature.

What is the purpose of influenza vaccination declination form?

The purpose of the influenza vaccination declination form is to document an individual's decision to decline receiving the influenza vaccine.

What information must be reported on influenza vaccination declination form?

The information typically reported on the influenza vaccination declination form includes the individual's name, contact information, reason for declining the vaccine, and signature.

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