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How to use or fill out varicella declination form with our platform
- Click ‘Get Form’ to open the varicella declination form in the editor.
- Begin by entering your personal information, including your name, phone number, and UCSD Employee ID. This ensures that your submission is properly tracked.
- Review the vaccine information statement provided in the document. This section outlines the importance of vaccination and potential risks associated with varicella infection.
- Choose one of the options regarding your participation in the Varicella vaccine program. Make sure to read each option carefully before making your selection.
- If applicable, list any prior varicella vaccinations you have received along with their dates. This information is crucial for maintaining accurate health records.
- Sign and date the form at the bottom to confirm your choices and understanding of the risks involved.
- Finally, return the completed form to the Occupational Health Nurse via fax or mail as indicated in the instructions.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2014 | 4 Satisfied (43 Votes) |
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