Hepatitis-B Form

Employee Name

Consent

Please bring proof you have had a Hep-B Vaccine injection.

Upload the proof of your Hep-B vaccine injection here

Max. file size: 512 MB.

Signature

Date

MM slash DD slash YYYY

If you do not want to take the flu vaccine, kindly download and sign the document here.

Once you’re done, you can upload it directly below.

Consent

I decline to have a Hep-B Vaccine injection.

Upload File

Max. file size: 512 MB.

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