Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural...
5
Transcript of Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural...
![Page 1: Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural beliefs/conscientious/other exemption. Decline Parent / Legal Representative Initials](https://reader036.fdocuments.in/reader036/viewer/2022070221/613b0e07f8f21c0c8268c98d/html5/thumbnails/1.jpg)
![Page 2: Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural beliefs/conscientious/other exemption. Decline Parent / Legal Representative Initials](https://reader036.fdocuments.in/reader036/viewer/2022070221/613b0e07f8f21c0c8268c98d/html5/thumbnails/2.jpg)
![Page 3: Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural beliefs/conscientious/other exemption. Decline Parent / Legal Representative Initials](https://reader036.fdocuments.in/reader036/viewer/2022070221/613b0e07f8f21c0c8268c98d/html5/thumbnails/3.jpg)
![Page 4: Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural beliefs/conscientious/other exemption. Decline Parent / Legal Representative Initials](https://reader036.fdocuments.in/reader036/viewer/2022070221/613b0e07f8f21c0c8268c98d/html5/thumbnails/4.jpg)
![Page 5: Scanned Document...I decline the vaccine(s) offered to the minor today due to religious/cultural beliefs/conscientious/other exemption. Decline Parent / Legal Representative Initials](https://reader036.fdocuments.in/reader036/viewer/2022070221/613b0e07f8f21c0c8268c98d/html5/thumbnails/5.jpg)