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Northern Arizona University Environmental Health and Safety Hepatitis B Vaccination Consent or Declination Form 2014 I understand that all employees who are 
 Hepatitis B Vaccination Acceptance/Declination Hepatitis B vaccine is available to all workers who could be expected to come Have your supervisor sign this form.
 HEPATITIS B VACCINE ACCEPTANCE/DECLINATION FORM . ACCEPTANCE: I understand that due to my occupational exposure to blood or other potentially infectious
 HEPATITIS B VIRUS (HBV) VACCINE DECLINATION FORM Declination Statement I understand that due to my occupational exposure to blood or other potentially infectious
 Hepatitis B Vaccination Declination or Request Instructions: Employee completes Part I and submits to Unit Head. Unit Head completes Part II and files this form in
 Hepatitis B and a Healthy Baby - This slide set is audio-visual educational tool that describes the importance of getting babies vaccinated against hepatitis B if a 
 Hepatitis B Vaccination Acceptance or Declination Form. Instructions: Complete the Employee/Student information below. Determine whether or not you wish to receive
 Declination Form: Hepatitis-B Vaccine Name of Employee:_____ I voluntarily decline the Hepatitis-B vaccine at 
 Hepatitis B Vaccine Declination (Mandatory) I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of 
 I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring hepatitis B virus (HBV) infection 
 HEPATITIS B VACCINATION DECLINATION FORM Date: Employee Name: Employee ID#: I understand that due to my occupational exposure to blood or other potential 
 HEPATITIS B VACCINATION DECLINATION FORM Date: Employee Name: Employee ID#: I understand that due to my occupational exposure to blood or other potential 
 Hepatitis B Vaccination Declination Form . Please complete the appropriate section below, maintain a copy for your records and send a copy to the
 HEPATITIS B IMMUNIZATION CONSENT/WAIVER FORM [By law, the Hepatitis B vaccine series will be made available to employees within 10 days of initial assignment to a 
 Hepatitis B Vaccination Declination Statement Form - Forms 7.10 Hepatitis B Vaccination Declination Statement Form - Forms 7.10 McNeese State University

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