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Meningococcal Disease Response

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Electronic Meningococcal Meningitis Response

If you have not received the Meningococcal vaccine within the last 5 years, and you agree with the statement below, please complete the form below.

Response Form.

I have read, or have had explained to me, the information regarding Meningococcal disease.  I understand the risks of not receiving the vaccine.  I have decided that I (my child) will not obtain immunization against Meningococcal disease.

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