DO NOT SIGN the Refusal to Vaccinate form! 2017-11-24T20:53:36+00:00

DO NOT SIGN the Refusal to Vaccinate form – It’s a trap!

This article is not the original, but a redistrubution provided by Parents Against Mandatory Vaccines

THE REFUSAL TO VACCINATE DOCUMENT

The Refusal to Vaccinate document was created by the CDC or the American Academy of Pediatrics ‘legal department’ as a response to the growing number of toxic vaccines recommended by them and the growing number of parents who are becoming educated on this issue. According to CDC recommendations, our children should now receive 37 doses of vaccines between 0-16 years.

[See Vaccine Schedule]

This document, now being used to overcome vaccine awareness, is the most diabolical strategy possible! It is unlikely that physicians have any idea what they are asking their patients to sign . . . or to sign away. It is essentially a signed confession. So please read and understand why no one should sign it and why it is really something other than what it appears to be.

TWELVE REASONS YOU CANNOT SIGN REFUSAL TO VACCINATE

Here are 12 reasons why no parent can sign this document unless they are interested in being statutorily charged with neglect or intentionally causing harm. Repeating more boldly: this document, if signed, could be used to have your child(ren) removed from your custody! It was created to stand up in court, which is why they require the parent’s signature to be “witnessed”?

Refusal to Vaccinate 3

#1
The document attaches a child ID # that will be identifiable in the electronic records system across the country. Everyone from the school to the NSA will be able to determine who is and who is not vaccinated.

#2
The scientific term for HPV vaccine is listed to discourage parents from making the connection to the dangerous vaccine for HPV called Gardasil. [See Gardasil: Former Merck Doctor predicts greatest medical scandal of all time]

#3
Establishing a vaccination history is part of the Police state registry system being set up to track your vaccination status.

#4
The CDC Vaccine Information Statement is pure unadulterated propaganda. The vaccination information coverup was documented and exposed in an extremely important paper Health Hazards of Disease Prevention (2011). Also see info about the CDC – #9 (below).

#5
Again the parent is misled to think the truth about vaccine risks is on the CDC web site.The doctor has the vaccine package inserts right in his/her office. Why is it not offered and explained to the parent? The physicians themselves may or may not have read them. However, physicians are certainly aware that if the parents read the ‘official risks’ put out by the drug corporations, they would refuse the vaccines. Full disclosure is almost NEVER a part of the process.

#6
“I understand the following: The risks and benefits of the recommended vaccine(s).” This of course would be agreeing to a false statement. You cannot understand the risks without reading and understanding the package inserts, therefore how can you answer in the affirmative? And what about all of the vaccine facts that aren’t even listed in the package inserts that have been ‘covered up’ for many years?

#7
Parents are falsely told that without vaccines their children could suffer dire illnesses but are not told the dire illnesses/injuries the vaccines themselves could cause . . . including death.

#8
This refers to the “herd immunity myth” of 1933, which has been proven unscientific over and over and over again. Simply put: if other children have been vaccinated – and the vaccines work – they won’t contract a disease from your child.

#9
Entities are listed as “strongly recommending” the vaccine schedule. Again however, parents are NOT given full disclosure as to exactly who/what the entities are and what their motivations might be. Listed on the Refusal to Vaccinate document are the following entities and a brief description of their motivation:

  • The ‘physician’ – is rewarded for administering vaccines by higher reimbursements for his fees. His vaccine “rates” are checked to determine whether or not he/she is entitled to more money. Physicians, public health workers, and drug companies have all been given immunity from any possible lawsuits that may arise as a result of vaccine-caused injury or illness. In other words, if a vaccine harms your child or causes autism you cannot sue any of them. They all have a liability exemption.
  • The American Academy of Pediatrics which is a corporation headquartered in the STATE OF ILLINOIS – that receives lots of money from drug corporations for advertising in their journal, etc. This organization relies heavily on what they falsely believe to be a “government” health advocacy agency known as the Center for Disease Control (CDC).
  • The American Academy of Family Physicians which is a corporation headquartered in the STATE OF KANSAS – that also receives lots of money from drug corporations for advertising in their journal, etc. This organization also relies heavily on what they falsely believe to be a “government” health advocacy agency known as the Center for Disease Control (CDC).
  • The Center for Disease Control (CDC) which is a corporation headquartered in the STATE OF GEORGIA. The CDC IS NOT PART OF A LEGITIMATE GOVERNMENT. Repeat: the CDC IS NOT PART OF A LEGITIMATE GOVERNMENT! It is a private for-profit corporation listed on Dun and Bradstreet that is chartered under the umbrella of the private for-profit UNITED STATES corporation with extremely close ties to the pharmaceutical companies and a sordid history of corruption. [See: CDC Exposed]

Bottom line: all of the above “entities” make more money if they vaccinate our children and even more if our children get sick from the vaccines . . . including the pediatricians themselves.

#10
This is the broadest and most nefarious part of this document.
“Nevertheless, I have decided at this time to decline . . . I know that failure to follow the recommendations about vaccination may endanger the health or life of my child and others . . . I therefore agree to tell all health care professionals in all settings what vaccines my child has not received because he or she may need to be isolated or may require immediate medical evaluation and tests that might not be necessary if my child had been vaccinated.”

This is not only deceptive and untruthful [see numbers 2-8] it is asking you to confess that you know you are harming your child (and others) and don’t care. It is asking you to agree to inform any/all people who represent themselves as healthcare “professionals” (not defined) of your child’s vaccination record. You are also consenting to allow undefined healthcare professionals to remove your son or daughter from your care and place him or her in isolation for unproven or unknown exposure to a myriad of undefined communicable diseases – with or without testing.

#11
This is an admission that you understand this contractual document – and its significance – ‘in its entirety’. This means that you accept the false information sited as factual, chose NOT to do what you now know to be good for your child and others (are negligent), obligate yourself to embarrass and confuse your child by tracking and reporting on the vaccines you protected your child from, and give permission for your child to be tested or removed from your care and put in isolation for any ‘supposed’ exposure to any ‘undefined’ communicable disease by anyone calling themselves a healthcare worker. [Ohio Revised Code 3701.13]

In short, the form wants you to attest to the following . . . in writing and in the presence of a witness:

  • You understand you are signing a contract with performance requirements
  • You accept false information as factual and don’t care
  • You don’t care if your child or others are harmed by your decision
  • You agree to volunteer to all pretend healthcare workers your child’s vaccine record
  • You agree to allow others to test and/or isolate your child for unproven exposure to a disease

#12
Here is the kicker. As you are asked to sign, initial and date this document in front of a witness, should a custody dispute ever arise (either between parents or with Child Protective Services) this document could be used against the mother or father that signed it.

In defense of physicians, they have been told – via the instructions accompanying the Refusal to Vaccinate document – that parents could sue them should their sons or daughters come down with any of the diseases vaccines are supposed to prevent. Their fear of being sued is why physicians are so insistent that parents sign the Refusal to Vaccinate document.  An excellent alternative, for both physician and parent, is the Vaccination Notice.  This notice corrects misconceptions about vaccines, the herd immunity myth, and the CDC. It also brings the liability (or lack thereof) to the physicians attention. See The Vaccination Notice.

 

WHAT IF I ALEADY SIGNED THE REFUSAL TO VACCINATE DOCUMENT?

Start by asking for the original back. Tell the doctor (or whoever) that your “family” decided for many reasons (we came up with 12) that it was not good to have it in your (or your child’s) file. It is best not to offer any more information than that or engage in any discussion, but to remain firm but pleasant. When it comes to vaccines, anything you tell them can be used against you, believe it or not!

The doctors have been warned that if they don’t have this form on file, the parent could sue the doctor should the child get one of the diseases the vaccine was ‘supposed’ to prevent. The lawyers for the vaccine agenda have pitted the doctors against the health and safety of their patients. Sad, huh? We have proof of this because we’ve read the instruction page that accompanied the Refusal to Vaccinate form that was given to physicians, et al.

If the doctor’s office does not cooperate, you will have to send them a certified letter “rescinding your signature” thus nullifying the form. It is also recommended that you send them a Vaccination Notice (see next topic) to end all disputes regarding vaccines.

Here is a sample letter reflecting what I would write:

Dear Doctor Bloohoo,

Unfortunately, I mistakenly signed the Refusal to Vaccinate form regarding my son (or daughter) that your office asked me to sign. After discussion with my family, I have decided that this form was not in our best interest to sign and have placed in my son’s (or daughter’s) file.

I hereby rescind my signature on that form making it null and void and require that your office return the original to me.

I (we) have concluded, after much research, that vaccinations today are neither safe nor effective and that the theory of “herd immunity” has been scientifically proven invalid many times.  So I am sending you my (our) own Vaccination Notice. Please include this notice in my son’s (or daughter’s) medical record.

Appreciatively,

Jane Doe (Mother of Sally Doe)
125 Maple Canyon
Canton, Ohio

 

WHAT IS A VACCINATION NOTICE?

INTRODUCTION to VACCINATION NOTICES (read first)

The pressure (and monetary rewards) has been steadily increasing for physicians to comply with all CDC recommendations. Should your physician request to vaccinate you or your child ask to see the drug company’s package insert (not a brochure or handout) for the product he/she wishes to inject. Tell him/her that you wish to take it home and read it over with your family. Of course, once you read it you will see why so many folks today are saying no to vaccinations and why these inserts are rarely given to the parent or patient. During your next visit politely tell the physician or nurse that you are not comfortable with the vaccine risks.

Many physician offices are now asking parents who wish to protect their children from toxic vaccines to sign a Refusal to Vaccinate document. These physicians have been told that this document will protect them from being sued by the parent should the child come down with the disease the vaccine was supposed to prevent.

DO NOT SIGN the Refusal to Vaccinate document as it can be used against you in court.  Instead tell the physician you have an alternative document that will serve the same purpose and give him/her your Vaccination Notice requesting that it be placed in the medical record.  The ‘same purpose served’ is the reduction of your ability to sue the physician should your child get the disease the vaccine is supposed to prevent.

FILLING OUT THE NOTICE

  • Download the LAWFULLY YOURS pdf guide posted at the bottom of this page and the Word Doc templates for Vaccination Notices are linked right below it. Select the one(s) you wish to use.
  • Items in grey need to be personalized
  • Select son or daughter as applicable
  • Corporate entities need to be in all caps
  • The health department of each state is listed in its corporate name on the Dun and Bradstreet website
  • Sign the notice in red ink and obtain the signatures of two witnesses or one notary

It is essential to read, understand and agree with the notice before you sign and deliver it. 

DELIVERING THE NOTICE
The notice requires little discussion. Just hand it to the doctor or nurse and request it be placed in your (or your child’s) record. Should you be asked where you obtained the notice, simply say from another parent, which is true. Giving more information is not required nor recommended. Citing websites or vaccine aware groups or authors just serves to motivate those in the vaccination-distribution-business to track down and discredit (or worse) the folks that are doing their best to bring good information to the public. The less said the better. Let the notice speak for you.

Keep a copy of the notice for yourself and ask the nurse or doctor to sign “received on (date)” and sign below it. Should the physician or their office be uncooperative let it go. Proceed by sending the notice certified mail – receipt requested – to their office.  In future encounters with the physician’s office just refer to the notice of non-consent that is in your file.

More methods of empowering yourself in our commercial (UCC) legal system can be found in the LAWFULLY YOURS guide