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Declination form 2026
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- Click ‘Get Form’ to open the declination form in the editor.
- Begin by entering the facility name in the designated field at the top of the form.
- Read through the provided information regarding the influenza vaccine, ensuring you understand its risks and benefits.
- In the section where you indicate your choice, select one of the options: either declining the vaccine or stating that you have already received it this flu season.
- If you are declining, simply check the first box. If you have already received it, check the second box and fill in where you received it.
- Print your name clearly in the 'Employee’s Name' field, followed by your signature and date to finalize your declination.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2009 | 4.8 Satisfied (235 Votes) |
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covid vaccine declination form
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