2015-2016 Flu Vaccination Compliance Requirements
This file contains information about flu vaccination compliance for SHC Medical Staff for the 2015-2016 flu season. It includes vaccination deadlines, reporting protocols, and vaccine schedules. Additionally, it outlines the consequences of non-compliance.
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How do I fill this out?
To fill out this form, you need to provide documentation proving that you have received a flu vaccination. If you have a medical or religious exemption, you will need to declare it accordingly. Follow the instructions provided to ensure your compliance.

How to fill out the 2015-2016 Flu Vaccination Compliance Requirements?
1
Locate the required documentation proving your flu vaccination.
2
If applicable, declare any medical or religious exemption.
3
Submit the documentation to the designated email address.
4
Attend the scheduled flu vaccine clinics for vaccination.
5
Ensure you meet the deadline for submission.
Who needs the 2015-2016 Flu Vaccination Compliance Requirements?
1
SHC Medical Staff needs this file to comply with flu vaccination mandates.
2
Healthcare workers need this file to provide proof of their flu vaccination.
3
Human Resources departments need this file for employee health compliance.
4
Occupational Health Services need this file to track staff vaccination status.
5
Employees with medical or religious exemptions need this file to declare their status.
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What are the instructions for submitting this form?
Submit the completed flu vaccination compliance form and supporting documentation to flu@stanfordhealthcare.org. You can also send it via fax to the Occupational Health Services office or deliver it in person at the Main Hospital. Ensure all documentation is received by November 1, 2015. My advice is to meet the deadlines promptly to avoid suspension of privileges or loss of access to essential systems. Follow all detailed instructions on the form for a smooth submission process.
What are the important dates for this form in 2024 and 2025?
Important dates for this form in 2024 and 2025 include: November 1, 2024 - Flu vaccination deadline; November 3, 2024 - Non-compliance suspension begins; March 31, 2025 - Flu season concludes.

What is the purpose of this form?
The purpose of this form is to ensure SHC Medical Staff comply with flu vaccination mandates for the 2015-2016 flu season. It aims to protect the health of medical staff, co-workers, and patients by making vaccination mandatory or requiring a declared exemption. The form outlines reporting protocols, vaccination schedules, and consequences for non-compliance.

Tell me about this form and its components and fields line-by-line.

- 1. Documentation Proof: A section to upload or attach proof of flu vaccination.
- 2. Exemption Declaration: A section for medical staff to declare medical or religious exemptions.
- 3. Vaccination Dates: A section to document the dates of flu vaccination or exemption declaration.
- 4. Submission Information: Instructions on how to submit the form and where to send it.
What happens if I fail to submit this form?
Failure to submit this form results in suspension of privileges and loss of access to EPIC.
- Suspension of Privileges: Medical staff privileges will be suspended until compliance is met.
- Loss of EPIC Access: Access to the EPIC system will be revoked for non-compliant staff.
How do I know when to use this form?

- 1. Flu Vaccination Compliance: Submit documentation proving your flu vaccination.
- 2. Medical Exemption: Declare any medical reasons preventing you from getting vaccinated.
- 3. Religious Exemption: Declare any religious reasons preventing you from getting vaccinated.
- 4. Vaccination Status Tracking: Allow HR and Occupational Health to track your vaccination status.
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