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HEPATITIS B <br /> VACCINE <br /> NZ <br /> All medical personnel, who could be reasonably anticipated as the result of performing their <br /> DELTAjob duties to face contact with blood and other potentially infectious materials, should be <br /> HEALTHvaccinated for Hepatitis B Virus. <br /> An employee may choose not to receive these vaccinations. However, Delta Health Care will <br /> Providing Health Oriented not assume responsibility for any employee who refuses to be vaccinated should they <br /> Services and Information <br /> to the Community subsequently contract Hepatitis B. <br /> I understand Delta Health Care's policy as it relates to Hepatitis B vaccinations. <br /> I will schedule and appointment by and bring written <br /> verification to the clinic. <br /> I refuse to receive the vaccinations. I understand that Delta Health <br /> Care will not assume liability should I become ill. I may choose to <br /> receive the vaccination at a later date. <br /> Signed: Date: <br /> Witnessed: Date: <br /> 914 N.Center Street <br /> Stockton,CA <br /> 95202 <br /> 209/466-3245 <br /> 911 Industrial Way <br /> Lodi,CA <br /> 95240 <br /> 209/369-2704 <br /> HE182.194 <br /> R.i.d 01/94 <br /> G..." <br /> United Way <br /> of Sm,wawin county <br />