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Hepatitis b declination form dental 2026
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- 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 one of the options regarding your vaccination status. You can either indicate that you have received the Hepatitis B vaccine series or choose to decline it at this time.
- Fill in the date next to your selected option to document 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.
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Related links
The following statement of declination of hepatitis B vaccination must be signed by an employee who chooses not to accept the vaccine.Read more
I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If in the future, I continue to haveRead more