Refusal to Vaccinate Form

About this template

Document guardian refusals to vaccinate their children with Jotform’s Refusal to Vaccinate Form template. Instead of printing out paper copies and waiting for physical signatures, Jotform Sign allows you to go paperless and get your forms filled out quickly and efficiently. Simply customize to your liking, send out, and collect the signatures you need from parents or guardians. You’ll receive a notification and a finalized version of the document once each signature has been collected.

Need to make changes to this Refusal to Vaccinate Form template? Use our intuitive drag-and-drop form builder to add images, change fonts and colors, add more signature fields, and more. Once your Refusal to Vaccine Form is filled out and completed, you can instantly download it for your records or share it with other involved parties. Create a signature form that works best for your office with Jotform Sign.

Related templates

Professional Medical Consent Template

Create a signable professional medical consent form in seconds. Easy to customize. Fill out and sign on any device. Share via email. No coding knowledge required.

Medical Records Release Authorization

Build a medical records release authorization form in seconds. Works on any device. Android and iOS compatible. Converts to a PDF. No coding knowledge required.

Pregnancy Verification Template

Verify the pregnancies of your clinic’s patients easily. Drag and drop to customize your form. Send out copies. Works on desktop, tablet, and mobile devices.

Online Therapy Consent Template

Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.

Vaccine Exemption Letter

Create and customize a vaccine exemption letter to match your needs. Drag and drop to design. Works on smartphone, tablet, and desktop devices. No coding.

Positive COVID Test Results Letter

Generate positive COVID-19 test results letter for your practice. Fill out and sign quickly on any device. Customize with our drag-and-drop builder.

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.