CON Request for Waiver of Faculty Immunizations or CPR Requirements: Difference between revisions
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<p style="margin-bottom:150px;">I, ________________________________________________, request a waiver of requirements for the following immunization(s) and or CPR, and include a signed statement from my primary care provider if for medical reasons:</p> | <p style="margin-bottom:150px; max-width:70em !important;">I, ________________________________________________, request a waiver of requirements for the following immunization(s) and or CPR, and include a signed statement from my primary care provider if for medical reasons:</p> | ||
<p style="margin-bottom:150px;">for the following reason(s):</p> | <p style="margin-bottom:150px;">for the following reason(s):</p> | ||
<table style="max-width:70em !important;" width="100%" cellspacing="0" cellpadding="0" border="0"> | <table style="max-width:70em !important;" width="100%" cellspacing="0" cellpadding="0" border="0"> |
Revision as of 15:49, May 6, 2015
Home | Appendices |
UNIVERSITY OF NEBRASKA MEDICAL CENTER COLLEGE OF NURSING |
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Request for Waiver of Faculty Immunizations or CPR Requirements(Subsection 4.2.12 in Resource Manual) | Subsection: Appendix M | |
Section - Information | Originating Date: October, 2003 | |
Responsible Reviewing Agency: Executive Council Faculty Coordinating Council |
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J:/RESOURCE MANUAL/Table of Contents College of Nursing Resource Manual |
I, ________________________________________________, request a waiver of requirements for the following immunization(s) and or CPR, and include a signed statement from my primary care provider if for medical reasons:
for the following reason(s):
_______________________________________________ | _______________________________ | |
Faculty Signature | Date | |
_______________________________________________ | _______________________________ | |
Department Chair/Division Assistant Dean Signature | Date | |