Hepatitis b declination form dental: Fill out & sign online

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out hepatitis b declination form dental with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the hepatitis B declination form in the editor.
Begin by entering your name in the designated field. Ensure that you print your name clearly for accurate identification.
Next, select the appropriate option regarding your vaccination status. You can either check 'I have received the Hepatitis B vaccine series' or 'I decline the Hepatitis B vaccination at this time.'
Fill in the date next to your selected option to indicate when you made this decision.
Finally, sign and date the form at the bottom. This confirms your understanding of the risks associated with declining vaccination.

Start using our platform today to fill out your hepatitis B declination form easily and for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Contact us

Do you need a hep B vaccination as a dental assistant?

2) Hepatitis B Vaccine Waiver I have been given the opportunity to be vaccinated with hepatitis B vaccine at no charge to myself; however, ☐ I decline the hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease.

What is a declination form for hep B?

some may be recommended by government agencies For example, while the Hepatitis B vaccine is recommended by the Occupational Safety and Health Administration (OSHA), employees may opt-out of getting the vaccine unless its mandated by hospital policy or state law.

What is a hepatitis B waiver?

DECLINATION: I understand that due to my occupational exposure to blood or other poten tially infectious materials that I may be at risk of acquiring Hepatitis B Virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine. However, I decline Hepatitis B vaccination at this time.