Vaccination Notice of Non-consent for Physicians and Schools

https://anticorruptionsociety.files.wordpress.com/2015/08/lawfully-yours-seventh-edition-aug-2015.pdf

Look for pages 30 through 35 for vaccine non-consent templates.

See below,  but for proper formatting etc. go to link above.

page 30

Vaccination Notice of Non-consent for Physicians and Schools

Before submitting a vaccination notice to the physician, request the package insert for the vaccine he/she wishes to give you or your child. Do not accept CDC vaccine information sheets as a substitute. Do not decide while in his/her office, but take it home and read it. DO NOT SIGN ANY VACCINE REFUSAL FORMS(5)
the doctor or nurse offers you. It is imperative that you present your own notice to them instead. The following notice is written from the point of view of a well informed rational parent, because most certainly the benefits of today’s vaccines
do not outweigh the risks.

The Vaccination Notice(6) is designed to inform the doctor, hospital or school of the reasons you are opposed to their administering vaccines to your child and that you will only consent if they agree to accept the liability – in writing, which they would never do. The statements listed on the notice are factual and easy to validate. This approach should help put an end to the endless arguments that pediatricians and others inflict on vaccine-aware parents.

FILLING OUT THE NOTICE
1. Items in grey need to be personalized.
2. Select son or daughter as applicable.
3. Corporate entities need to be in all caps.
4. The health department of each state is listed in its corporate name in all caps on Dun and Bradstreet. That
information is accessible for free online.
5. At the bottom of the notice is a space for the parent’s signature and the signature of two witnesses. Of course
the dates need to be identical. An acceptable alternative to two witnesses would be to sign in front of a notary
and have them stamp it for you. Use blue ink for signatures.

DELIVERING THE NOTICE
This notice requires little discussion. Just hand it to the nurse or doctor. Politely explain that you are not comfortable with the vaccine risks and wish to have this notice placed in the child’s records so you don’t have to bring in a new one each time your child sees the doctor or nurse. If asked where you obtained the document, simply say from another parent, which is true. Giving more information is neither required nor advisable. Citing websites or vaccine-aware organizations just motivates those in the vaccination-distribution-business to track down and discredit folks that are doing their best to bring good information to the public. And, frankly where you get your information is none of their business.

Do not answer detailed questions about your objections to any vaccine. Just repeat what is on the notice; “I am aware of multiple scientific peer-reviewed papers that have exposed the dangers of many vaccines.” Doctors and
nurses are well armed with ‘talking points’ designed to overcome all claims you might make regarding vaccines and nearly all authors you might site. According to Russell Blaylock, MD there are lots of peer-reviewed articles on this topic for doctors and nurses to read. It is their job to seek this information. It is not your job to provide it to them. The notice just states facts and is designed to be self-explanatory.

Should the clerk, doctor, or nurse refuse to accept your notice, remind them that legal notices are an important element in due process. Keep a copy for yourself and put the name of the employee who accepted (or rejected) the notice and the date it was delivered on the bottom of the page.

Should school employees refuse to place the notice in your son or daughter’s file, refer them to the “Notice to agent is notice to principal clause”. Write Notice refused by Agent (first and last name) on such and such date in the space at the top of the notice. Then take the notice home and send it certified mail (with return receipt) to the Superintendent of the school. Include a short explanatory letter. Following is a sample letter for the school superintendent.

5
For more information go to ParentsAgainstMandatoryVaccines.com; “DO NOT SIGN”
6
See Notice http://legal-dictionary.thefreedictionary.com/Notice

Page 31

SAMPLE IV – single page notice –
VACCINATION NOTICE
Notice to agent is notice to principal – Notice to principal is notice to agent

As the living flesh and blood mother of Sally Doe Sally Doe (whose address is 2525 Maple Lane, Grove City, Ohio (no zip)), I am prohibited by law from endangering my son or daughter; therefore, I declare the following 1) I am aware that those ordering and/or administering vaccines have been granted immunity from liability should my son or daughter suffer from a vaccine caused injury or illness. Since the Supreme Court decision Bruesewitz v. Wyeth (Feb 22, 2011), drug companies are under no legal obligation to insure their vaccine products are either safe or effective. The same decision defined vaccines as unavoidably unsafe. The Vaccine Injury Compensation Trust Fund is not an acceptable
alternative to me. (Reason listed below – #10)

2) Unless I receive the vaccine manufacturer’s package inserts, I have not been given full disclosure regarding any vaccine.
CDC or public health vaccine information sheets and/or websites are not acceptable alternatives. (Reasons listed below – #4 & #5)

3) I am aware that vaccine schedules have been established by the CDC and are promoted by public health departments, the American Academy of Pediatrics and other organizations. I do not accept CDC recommendations as science-based. (Reasons listed below – #4 & #6)

4) I do not recognize the CDC as a government health advocacy organization. It is a corporation listed on Dun and Bradstreet and headquartered in the STATE OF GEORGIA, with strong ties to the pharmaceutical industry. Therefore, their
recommendations are influenced by the ‘fiscal’ health of their corporation.
5) I am aware that physician records are reviewed by the HEALTH, OHIO DEPARTMENT OF, a corporation headquartered in COLUMBUS OH and listed on Dun and Bradstreet, and who receive monetary compensation from the CDC to perform this function. Therefore, the state public health department’s recommendations and actions are influenced by the ‘fiscal’ health of their corporation.

6) I do not recognize the AMERICAN ACADEMY OF PEDIATRICS nor the AMERICAN ACADEMY OF FAMILY PHYSICIANS as health advocacy organizations. They are both corporations (listed on Dun and Bradstreet) that are
headquartered in the STATE OF ILLINOIS and the STATE OF KANSAS respectively, whose monetary compensation from the vaccine manufacturers contributes to the ‘fiscal’ health of their corporations.
7) I am aware that many physicians are paid higher reimbursement rates for administering vaccines.
8) I am aware that LEGISLATORS for the corporation known as the STATE OF OHIO, listed on Dun and Bradstreet, vote on statutes and rules for the STATE OF OHIO. As the LEGISLATORS have no medical training and can easily be
influenced by drug company lobbyists and/or the CDC, I do not accept their corporate statutory vaccination mandates as science-based.

9) I am aware of multiple scientific peer-reviewed papers that have exposed the dangers of many vaccines as well as the “herd immunity myth” of 1933.

10) I am aware that the corporation HEALTH & HUMAN SERVICES, UNITED STATES DEPARTMENT OF (listed on Dun and Bradstreet and headquartered in WASHINGTON DC) determines claims paid from the Vaccine Injury
Compensation Trust Fund via a secret administrative process and also profits from vaccine patents.
11) I have concluded that failure to follow the CDC recommendations about vaccinations is less likely to endanger the health or life of my son (or daughter) or other’s sons and daughters than following their recommendations.
For the reasons I have listed and more, I do not consent to anyone administering any vaccine to my son or daughter unless they provide me with the vaccine package insert, allow me to determine if the health risks are acceptable, and sign a document stating that they, in their professional and personal capacity, not me (and or my spouse) accept the responsibility for any injury or illness (as defined by the International Medical Council on Vaccination) the vaccine they administer might cause my progeny (property), Sally Doe.
NOTE: This document can be used to protect those that administer vaccines (physicians, nurses or others) or are obliged to adhere to corporate statutes from any punitive statutory actions or penalties.

Mother                                                        Signature:                                               Date:
Father:                                                        Signature:                                               Date:
Witness:                                                     Signature:                                               Date:
Witness:                                                     Signature:                                               Date:

Page 32

SAMPLE LETTER FOR SCHOOL SUPERINTENDENT

date

Name, Superintendent
NAME OF SCHOOL SYSTEM
street address
CITY, STATE ZIP

Dear Mr. name,

My (son or daughter), (first and last name), attends the (name of school) in your school district. On (date) I
delivered my Vaccination Notice to your agent, (first and last name) at (name of school). (He or she) denied my
lawful request to place my Vaccination Notice in my (son or daughter’s) school record. Your agent’s inaction
necessitated that I send my lawful Vaccination Notice directly to you. It is enclosed.

As stated on my Vaccination Notice, unless I receive a confirmation in writing from you that you – and/or your
school district – accepts the liability for any harm or injury the school mandated vaccines might cause my (son or
daughter), I consider (him or her) excepted (not exempted) from all vaccinations mandated by the legislators of
the corporation known as the STATE OF OHIO.

Please place my Vaccination Notice in my (son or daughter’s) school file and make a note on his or her record of
this permanent exception.

Appreciatively,

Signature

First and last name only
address
City, and State

Sent by certified mail, #XXXXXXXXXXXXXXXXX

Page 33

Vaccination Notice of Non-consent for Employers and Colleges
The following notice is designed to inform your employer of the conditions under which you will comply with their flu shot (or other vaccine) request. See Notice http://legal-dictionary.thefreedictionary.com/Notice

Before filling out and turning in this notice, employees must request the vaccine package insert (not the CDC vaccination information sheet) for the vaccine they are being asked to take. If the appropriate insert is provided, inform the employer that you must take it home to read and consider. DO NOT JUST READ IT AND HAND IT BACK. It could be used as evidence should you accept the vaccine and get injured by it.

If no insert is provided, fill out and deliver the Vaccine Notice (a). If the inset is provided use the Vaccination Notice (b). This Vaccination Notice was designed as a tool to help employees decline unreasonable flu shot (or other vaccine) requests . . . and hopefully keep their jobs.

FILLING OUT THE NOTICE
1. Items in grey need to be personalized.
2. Corporate entities need to be in all caps.
3. The health department of each state is listed in its corporate name in all caps on Dun and Bradstreet. That information is accessible for free online.
4. The report referenced in the notice can be read at ParentsAgainstMandatoryVaccines.com under the title:
Health Hazards of Disease Prevention
5. At the bottom of the notice is a space for the employee or student’s signature and the signature of two witnesses. Of course the dates need to be identical. An acceptable alternative to two witnesses would be to sign in front of a notary and have them stamp it for you. Use blue ink for signatures.

DELIVERING THE NOTICE
This notice requires little discussion. Just hand it to the department that notified the employee of the vaccine request. Politely explain that you are not yet able to make a decision regarding the employer’s vaccine request and you wish to notify them of the additional assurances you require before complying. Remember that there have been adults who were permanently severely disabled by vaccines – whose employers paid zero in compensation!
And for this very reason drug companies refused to stop making vaccines unless they were given immunity from liability. It is extremely unlikely your employer will provide a document accepting liability should you suffer illness or injury from the vaccine. If asked where you obtained the notice, simply say from another individual who shares your concerns, which is true. Giving more information is not required and is not advisable. Citing websites
or vaccine aware organizations just motivates those in the well funded vaccination-distribution-business to track down and discredit folks that are doing their best to bring good information to the public.

The notice just states indisputable facts and is designed to be self-explanatory. However, if you don’t understand all of the items on the notice and agree they are factual, do not use it. Keep a copy of the notice for yourself and write the name of the individual you gave it to and the date on the bottom of the notice. Should you be told your employer will not accept this notice, ask if they would prefer you sent it by certified mail to the head of the Department of Human Resources. Be sure to save a copy of the notice for your own records and write on it the
name of the individual who received it and the date. Always be polite and appear cooperative.

Page 34

SAMPLE V (a)
EMPLOYEE/STUDENT VACCINATION NOTICE (a) -single page notice
– As a living flesh and blood employee or student of XYZ MEDICAL CENTER, INC, I declare the following:
My employer or school is requesting that I accept a flu shot vaccine as a condition of my employment or enrollment.
1) I am aware that since Supreme Court decision Bruesewitz v. Wyeth (Feb 22, 2011) those manufacturing, ordering and/or administering vaccines have been granted immunity from liability should I suffer from a vaccine caused injury
or illness, such as Guillian Barre. The same decision defined vaccines as unavoidably unsafe. The Vaccine Injury Compensation Trust Fund is not an acceptable alternative to me. (Reason listed below – #7)

2) Enclosing the adverse effects of pharmaceutical products is common practice for pharmacists. So, unless I am provided the vaccine manufacturer’s package inserts, I will not have been given the information I need to make an informed decision regarding the risks of taking the vaccine. CDC, public health, or other vaccine information sheets and/or websites are not acceptable alternatives. (Reason listed below – #4).

3) I am aware that vaccine recommendations have been established by the CDC and are promoted by public health departments and other various organizations. I do not recognize these corporations as health advocacy institutions.
(Reasons listed below – #4 & #5)

4) I do not recognize the CDC as a government health advocacy organization. It is a corporation listed on Dun and Bradstreet and headquartered in the STATE OF GEORGIA, with strong ties to the pharmaceutical industry. Therefore,
their recommendations are influenced by the ‘fiscal’ health of their own corporation.
5) I do not recognize the HEALTH, OHIO DEPARTMENT OF as a government health advocacy organization. It is listed on Dun and Bradstreet, is headquartered in COLUMBUS OH, has strong ties to the CDC and the pharmaceutical industry and receives monetary compensation to promote vaccines. Therefore, the state public health department’s recommendations and actions are influenced by the ‘fiscal’ health of their own corporation.
6) I have seen peer-reviewed scientific reports, such as The vaccination policy and the Code of Practice of the Joint Committee on Vaccination and Immunisation (JCVI): are they at odds?, which have provided proof that governments
have been concealing the dangers of many vaccines as well as the “herd immunity myth”.

7) I am aware that the corporation HEALTH & HUMAN SERVICES, UNITED STATES DEPARTMENT OF (listed on Dun and Bradstreet and headquartered in WASHINGTON DC) determines claims paid from the Vaccine Injury
Compensation Trust Fund via a biased secret administrative process and also profits from vaccine patents.

8) I am unaware of any state statute that grants XYZ MEDICAL CENTER, INC, the authority to require employees or applicants to take a pharmaceutical product (that is not warranted as either safe or effective by the manufacturer) as a
condition of their employment or admission. If such a statute exists, please send me the name, number and effective date.

For the reasons I have listed and more, I cannot comply with XYZ MEDICAL CENTER, INC, vaccine request unless I am provided with the vaccine package insert, allowed to determine if the health risks are acceptable, and presented
with a document stating that XYZ MEDICAL CENTER, INC, (not the Vaccine Injury Compensation Trust Fund) agrees to be financially responsible for any and all injuries, illnesses or losses (as defined by the International Medical Council on Vaccination) this vaccine might cause to a living flesh and blood man or woman.

NOTE: Please place this notice in my employee records file.

Name:

Address:

Signature: Date

Witness: Date:

Witness: Date:
Notice to agent is notice to principal – Notice to principal is notice to agent

Page 35

SAMPLE V (b)
EMPLOYEE/STUDENT VACCINATION NOTICE (b)
As a living flesh and blood employee or student of XYZ MEDICAL CENTER, INC, I declare the following:
My employer or school is requesting that I accept a flu shot vaccine as a condition of my employment or enrollment.
1) I am aware that since Supreme Court decision Bruesewitz v. Wyeth (Feb 22, 2011) those manufacturing, ordering and/or administering vaccines have been granted immunity from liability should I suffer from a vaccine caused injury
or illness, such as Guillian Barre. The same decision defined vaccines as unavoidably unsafe. The Vaccine Injury Compensation Trust Fund is not an acceptable alternative to me. (Reason listed below – #7)

2) I requested, received and reviewed the manufacturer’s package insert for the vaccine I am being requested to take.
The possible adverse reactions listed on this insert, exposed health risks I am unwilling to take.

3) I am aware that vaccine recommendations have been established by the CDC and are promoted by public health departments and other various organizations. I do not recognize these corporations as health advocacy institutions.
(Reasons listed below – #4 & #5)

4) I do not recognize the CDC as a government health advocacy organization. It is a corporation listed on Dun and Bradstreet and headquartered in the STATE OF GEORGIA, with strong ties to the pharmaceutical industry. Therefore,
their recommendations are influenced by the ‘fiscal’ health of their own corporation.
5) I do not recognize the HEALTH, OHIO DEPARTMENT OF as a government health advocacy organization. It is listed on Dun and Bradstreet, is headquartered in COLUMBUS OH, has strong ties to the CDC and the pharmaceutical
industry and receives monetary compensation to promote vaccines. Therefore, the state public health department’s recommendations and actions are influenced by the ‘fiscal’ health of their own corporation.
6) I have seen peer-reviewed scientific reports, such as The vaccination policy and the Code of Practice of the Joint Committee on Vaccination and Immunisation (JCVI): are they at odds?, which have provided proof that governments have been concealing the dangers of many vaccines as well as the “herd mmunity myth”.

7) I am aware that the corporation HEALTH & HUMAN SERVICES, UNITED STATES DEPARTMENT OF (listed on Dun and Bradstreet and headquartered in WASHINGTON DC) determines claims paid from the Vaccine Injury Compensation Trust Fund via a biased secret administrative process and also profits from vaccine patents.

8) I am unaware of any state statute that grants XYZ MEDICAL CENTER, INC, the authority to require employees or applicants to take a pharmaceutical product (that is not warranted as either safe or effective by the manufacturer) as a condition of their employment or admission. If such a statute exists, please send me the name, number and effective date.

For the reasons I have listed and more, I cannot comply with XYZ MEDICAL CENTER, INC, vaccine request unless I am presented with a document stating that XYZ MEDICAL CENTER, INC, (not the Vaccine Injury Compensation Trust Fund) agrees to be financially responsible for any and all injuries, illnesses or losses (as defined by the International Medical Council on Vaccination) this vaccine might cause to a flesh and blood living man or woman.

NOTE: Please place this notice in my employee records file.

Name of employee:

Employee Address:

Employee signature: Date

Witness: Date:

Witness: Date:
Notice to agent is notice to principal – Notice to principal is notice to agent

– single page notice –

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