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Documenting a Refusal to Consent to Vaccination forms

The Refusal to Consent to Vaccination forms are a tool for office practices to use for documentation in the patient’s medical record. These forms were adapted from the American Academy of Pediatrics (AAP) forms.

The forms to document refusal to consent to vaccination for children, adolescents, and adults can be found on the Immunization Alliance of Michigan

This is not a waiver form. Click here for information about immunization waivers.