I understand that, due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring the Hepatitis B virus (HBV). I have been given the opportunity to be vaccinated with the Hepatitis B vaccine. However, I decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I remain at risk of acquiring Hepatitis B, a serious disease.
If, in the future, I continue to have occupational exposure to blood or other potentially infectious materials and I choose to receive the Hepatitis B vaccine, I may do so at any time.
