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Refusal to vaccinate form 2021-2025

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The document is a Modified AAP Refusal of Vaccination Form, which allows parents or guardians to formally decline recommended vaccinations for their child after being informed about the vaccines' purposes, risks, and benefits. It includes sections for listing specific vaccines, indicating whether they are accepted or declined, and requires signatures from the parent/guardian and a witness.

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How do you document parental refusal to have their children vaccinated?

For parents who refuse one or more recommended immunizations, document your conversation, the provision of the VIS(s), and have the parent sign the vaccine refusal form and keep the form in the patients medical record.

Can parents choose not to vaccinate?

Nothing is more troubling to a practitioner than when a parent makes a decision that could jeopardize their childs health, such as vaccination refusal. Ultimately, the parent has a right to refuse any medical intervention or treatment for their child, including a vaccine.

What is the form to decline immunizations?

For healthcare providers who want to assure that these parents fully understand the consequences, Immunize.org has produced a form titled Record of Vaccine Declination. This form facilitates and documents the discussion that a healthcare professional can have with parents about the risks of not having their child

What are the reasons to not get vaccinated?

Appendix I choose not to get any vaccines. I had COVID-19 recently, so the vaccine was unnecessary. I am not concerned about getting sick with COVID-19. My chances of getting infected with COVID-19 are low. I am allergic to the vaccine or there is another medical reason I cannot get the vaccine.

What are religious reasons for not being vaccinated?

Objection to vaccination was also related to: faith in divine protection and healing for Protestants, Catholics, Jewish and Muslims (10); the use of aborted fetal cells for vaccines production among Amish and Catholic communities (including during the COVID-19 outbreak when Senior Catholic leaders from the US and

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Which states have religious exemptions for vaccinations?

All states allow exemptions for medical reasons, and almost all states (except California, Mississippi and West Virginia) grant religious or philosophical exemptions for people who have sincerely held beliefs that prohibit immunizations.

Can I decline vaccines?

Thirty states and Washington D.C. allow exemptions for people who have religious objections to immunizations. Thirteen states allow exemptions for either religious or personal reasons. Two states, Louisiana and Minnesota, do not specify whether the non-medical exemption must be for religious or personal reasons.

Refusal to vaccinate form 2021-2025

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How do you document parental refusal to have their children vaccinated?

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