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VA Form 10-9050 HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM

VA Form 10-9050 HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM-2025

VA Form 10-9050 HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM Preview on Page 1

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The document is a vaccination exemption form for healthcare personnel at the VA, specifically for those requesting an exemption from receiving the seasonal influenza vaccine. It outlines the necessary steps and requirements for employees, volunteers, and trainees to either confirm vaccination or provide justification for exemption due to medical or religious reasons. The form also emphasizes the need for documentation and compliance with health guidelines, including wearing a face mask if not vaccinated.

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