We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.
We firmly believe in the safety of our vaccines.
We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention and the American Academy of Pediatrics
We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.
We firmly believe that vaccinating children and young adults may be the single most important health-promoting intervention that we perform as healthcare providers and that you can perform as parents/caregivers. The recommended vaccines and the vaccine schedule are the results of years and years of scientific study and data gathering on millions of children by thousands of our brightest scientists and physicians.
Because we are committed to protecting the health of your child(ren) through vaccination, we require all of our patients to be vaccinated on time. If your child is behind on vaccines at their time of transfer to our practice, we will begin a catch-up schedule to ensure that your child is brought up to date regarding current vaccines for age. If you choose to separate vaccines during the catch-up phase, they are to be scheduled a minimum of 2 weeks apart until the child is up to date.
If you should refuse to completely vaccinate your child, we will ask you to find another healthcare provider who shares your views. Please recognize that by not vaccinating, you are putting your child at unnecessary risk for life-threatening illness and disability, and even death. Our desire is not to remove the decision for or against vaccinating from the parents, however, we are committed to providing the safest environment possible for families who do choose to seek care here and fully support evidence based medicine.
As medical professionals, we feel very strongly that vaccinating your child on schedule with currently available vaccines is absolutely the right thing to do to protect all children and young adults. Please feel free to discuss any questions or concerns you may have about vaccines with your healthcare provider.
I have read & understand the above policy, and agree to vaccinating my child under the recommendations of the CDC and AAP. I can receive a copy of such recommended vaccine schedule by request at any time.
DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Your information will be encrypted.
Your browser does not support capabilities required for electronic signatures.