Influenza Vaccine Waiver/Declination

Craft Health
1650 38th Street, Suite 101E, Boulder, CO 80301
720-274-5974

Please complete either the Waiver or Declination section below

Influenza vaccine is STRONGLY RECOMMENDED FOR HEALTHCARE WORKERS, not only to protect themselves, but to reduce the chance of spreading influenza to our patients and community. Influenza infection can lead to serious complications and can be fatal, especially in elderly or sick persons. When infection occurs despite vaccination, it is usually milder. Craft Health is committed to the health and well-being of our employees, employee's families and patients, and considers influenza vaccination of all Craft Health employees a high PATIENT SAFETY priority. The influenza vaccine is provided to all Craft Health Employees at no cost.

Waiver - complete if not eligible to receive vaccine

Declination