Get the up-to-date flu declination form 2025 now

Show details

4.3 out of 5

45 votes

The document is a Seasonal Influenza Attestation/Declination Form from Broward Health, emphasizing the importance of annual influenza vaccination for healthcare workers to protect themselves and their patients. It outlines the serious health risks associated with influenza, the benefits of vaccination, and the potential consequences of declining the vaccine. The form also provides space for students to document their vaccination status or to formally decline the vaccine while acknowledging their understanding of the related health implications.

Here's how it works

01. Edit your flu declination form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send flu vaccine declination form 2024 via email, link, or fax. You can also download it, export it or print it out.

How to edit Flu declination form in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Working on documents with our feature-rich and intuitive PDF editor is easy. Make the steps below to fill out Flu declination form online quickly and easily:

Sign in to your account. Sign up with your credentials or create a free account to test the product before upgrading the subscription.
Import a document. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit Flu declination form. Quickly add and underline text, insert images, checkmarks, and signs, drop new fillable fields, and rearrange or delete pages from your paperwork.
Get the Flu declination form completed. Download your adjusted document, export it to the cloud, print it from the editor, or share it with other participants through a Shareable link or as an email attachment.

Benefit from DocHub, one of the most easy-to-use editors to rapidly manage your paperwork online!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a declination form for Hep B?

A hepatitis B declination form is a form your employer may give you to offer you the hepatitis B vaccine option due to the occupational risk of exposure to the virus. You can sign to either accept or decline the vaccination. If you decline now, you can accept it at a later date should you change your mind.

How to decline flu vaccine at work?

This facility has recommended that I receive influenza vaccination in order to protect myself and the patients I serve. I DO NOT WANT A FLU SHOT. I acknowledge that I am aware of the following facts: Influenza is a serious respiratory disease; on average, 36,000 Americans die every year from influenza-related causes.

What is the difference between flublok and fluzone?

Fluzone is approved for use in persons 6 months of age and older. Flublok is approved for use in persons 18 years of age and older. Fluzone High-Dose is approved for use in persons 65 years of age and older.

What is an example of declination?

Each location on Earth will have a magnetic declination equal to the angle between true north and magnetic north, depending on how the magnetic field lines cross that location. For example, London has a magnetic declination of -1 degree (almost 0) and Sydney has a declination of approximately 12 degrees.

What does declination form mean?

Declination form means the form that is signed by and collected from Clients who decline voter registration services. A Client refusing to sign the Voter Registration Form is also a Declination.

flu shot declination form

Flu declination form CDC Flu declination form pdf Sample letter to decline flu shot FLU SHOT declination form California Valid reasons to decline flu vaccine Declination of influenza vaccination for healthcare personnel Flu declination form florida Vaccine declination form template

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

What is declination in simple words?

a bending, sloping, or moving downward. deterioration; decline. a swerving or deviating, as from a standard. a polite refusal.

What are valid reasons to decline a flu shot?

6 reasons patients avoid flu vaccination Im healthy, so I dont need a flu vaccine. The flu vaccine isnt safe and can give me the flu. It is better to get sick with the flu. Ill wait until flu hits my area. I hate getting injections. I was vaccinated last year.

What to put on flu declination form?

I have been given the opportunity to be vaccinated against this infection at no charge to me. However, I decline this vaccination at this time. I understand that by declining this vaccine, I continue to be at increased risk of acquiring influenza.

Get the up-to-date flu declination form 2025 now

Here's how it works

How to edit Flu declination form in PDF format online

Complete this form in 5 minutes or less

Got questions?

What is a declination form for Hep B?

How to decline flu vaccine at work?

What is the difference between flublok and fluzone?

What is an example of declination?

What does declination form mean?

Complete this form in 5 minutes or less

People also ask

What is declination in simple words?

What are valid reasons to decline a flu shot?

What to put on flu declination form?

flu vaccine declination form 2023

Try more PDF tools