Covid Vaccine Declination Form - Web covid vaccine declination form. This is required by federal law. Uc staff and students only. Web give the appropriate vaccine information statement (vis) to the parent or legal representative before each vaccine is given. When parents refuse a recommended vaccine, document that you provided the vis(s), and have the parent sign the “record of vaccine declination.”. Web ucla form #530131 (rev 12/23) page 1 of 2. Web any personnel or staff seeking to decline vaccination must also complete section 1 (vaccine declination) and section 2 (signature) of this form. Personnel and staff who choose to pursue the declination option must fill out all applicable forms. All curi recommendations are based on current cdc criteria at the time of publication. Shared by edwardwrighton in coronavirus response forms.
All curi recommendations are based on current cdc criteria at the time of publication. Web give the appropriate vaccine information statement (vis) to the parent or legal representative before each vaccine is given. When parents refuse a recommended vaccine, document that you provided the vis(s), and have the parent sign the “record of vaccine declination.”. Web any personnel or staff seeking to decline vaccination must also complete section 1 (vaccine declination) and section 2 (signature) of this form. Personnel and staff who choose to pursue the declination option must fill out all applicable forms. Shared by edwardwrighton in coronavirus response forms. This is required by federal law. Web covid vaccine declination form. Web ucla form #530131 (rev 12/23) page 1 of 2. Uc staff and students only. I affirmatively decline the covid vaccine at this time.