Influenza Vaccine Declination Form

Updated by Keri Alker

Influenza Vaccine Declination E-Signature Document

Please complete all required fields in the below e-signature document. 

Once you have filled out the form, please download the signed form and save it to your device.

Upload this completed form to your Matchwell Profile in the Health Records section by selecting the Influenza Vaccine option.

Have any questions?

Reach out to Matchwell Support via the in-app chat or by email at support@wematchwell.com and we'll be happy to help!


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