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DSHS Form 10-565 Medical Exemption for Influenza Vaccination - Washington
What Is DSHS Form 10-565?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 10-565?
A: DSHS Form 10-565 is a medical exemption form for influenza vaccination in the state of Washington.
Q: What is the purpose of DSHS Form 10-565?
A: The purpose of DSHS Form 10-565 is to provide a medical exemption from receiving the influenza vaccination in Washington.
Q: Who can use DSHS Form 10-565?
A: Anyone in Washington who has a medical condition that prevents them from receiving the influenza vaccination can use DSHS Form 10-565.
Q: How do I fill out DSHS Form 10-565?
A: To fill out DSHS Form 10-565, you will need to provide your personal information, medical condition details, and a healthcare provider's signature.
Q: Is DSHS Form 10-565 specific to the influenza vaccination?
A: Yes, DSHS Form 10-565 is specifically for medical exemptions from receiving the influenza vaccination in Washington.
Q: What should I do after filling out DSHS Form 10-565?
A: After filling out DSHS Form 10-565, you should submit it to the appropriate entity, such as your school or employer, as required by their policies.
Form Details:
- Released on October 1, 2015;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 10-565 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
