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Immunotherapy Shipment Waiver

Immunotherapy Shipment Waiver 2025

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The document is a waiver for the shipment of Immunotherapy Vials, where the signer agrees to pay $10.00 and releases Wexford Allergy, Asthma & Immunology, LLC from liability for any loss or damage during shipment. It requires verification of the correct home delivery address and includes spaces for personal information and signatures.

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Click ‘Get Form’ to open the Immunotherapy Shipment Waiver in the editor.
Begin by entering your name in the designated field. This identifies you as the individual agreeing to the terms of the waiver.
Next, fill in your complete address, ensuring accuracy for proper delivery. Include your city, state, and zip code in their respective fields.
Review the statement regarding payment of $10.00 for shipment and ensure you understand that by signing, you release Wexford Allergy, Asthma & Immunology, LLC from liability.
Sign in the signature field provided for Patient/Parent/Legal Guardian and enter the date of signing.
Lastly, have a witness sign where indicated and fill in the shipment date to complete the form.

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How can I eSign my Immunotherapy Shipment Waiver from Gmail?

With DocHub, it’s pretty simple. The platform offers users an add-on called DocHub for Gmail, which you can locate in the Google Workspace Marketplace without being charged. Set it up and grant it access to your Google account. Open your email with your Immunotherapy Shipment Waiver attached and click on the add-on button in the right-side panel. Log in to your DocHub account, and import the file to our editor, where you can complete it and sign.

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