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Hepatitis B Vaccination Consent Form

Hepatitis B Vaccination Consent Form

Hepatitis B Vaccine Waiver

Please check off ONE of the following items *

Hepatitis B Vaccine Consent

Please check off the items that are applicable *

Important Information For Women

I have been advised that studies have not been conducted to determine the effect of the vaccination on a developing fetus. Therefore, the safety of the Hepatitis B Vaccine relating to the developing fetus is currently unknown.