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Atrium Health Moderate Sedation Protocol

Exemption forms: Influenza Vaccination

MEDICAL Exemption for Influenza Vaccination
If you need to request Medical Exemption from the Influenza Vaccination please complete this form and email/fax to Medical Staff Services.

RELIGIOUS Exemption for Influenza Vaccination 
If you need to request Religious Exemption from the Influenza Vaccination please complete this form and email/fax to Medical Staff Services.

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