You Want To Vaccinate My Child? Just Sign This Form

If you are pressured by any Physician to vaccinate yourself or your children, please download and print this form. Assertively state to your Doctor that it is the only way you will be fully informed to consider vaccination and that an analysis of the risks and benefits will better allow you to evaluate the decision.

100% of Physicians approached with this form have so far declined to sign it.

Physician’s Warranty of Vaccine Safety Form

Download PDF English
Physician’s Warranty of Vaccine Safety

Download PDF Espanol
Garantia Medica para la Seguridad en las Vacunas

Download PDF Francais
Formulaire a faire signer (Vaccines)

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