Release of Liability forms

Published

Specializes in Gen Surg, Peds, family med, geriatrics.

I'm in the process of setting up private flu shot clinics. Because of the risk of anaphylaxis, we require participants to wait in the clinic for 15 minutes post vaccine. In my experience most people have no problem waiting the 15 minutes, but there are a few who will not. We've decided to put together a release of liability form for them to sign should they decide to leave right away. IMO a lot of people would rather wait the 15 minutes rather than sign a form like that.

I've looked around the net but can't find a good template or example that I could use to write the letter. Does anyone know where I can find one?

Much appreciated.

Up Vote Up Vote ×
Specializes in Maternal - Child Health.

Interesting question.

I've never had a patient refuse to wait the 15 minutes. Perhaps you could modify a "leaving against medical advice" form.

Up Vote Up Vote ×
Specializes in Critical Care.

I would have an attorney write it for you.

Up Vote Up Vote ×
Specializes in NICU, Post-partum.
I'm in the process of setting up private flu shot clinics. Because of the risk of anaphylaxis, we require participants to wait in the clinic for 15 minutes post vaccine. In my experience most people have no problem waiting the 15 minutes, but there are a few who will not. We've decided to put together a release of liability form for them to sign should they decide to leave right away. IMO a lot of people would rather wait the 15 minutes rather than sign a form like that.

I've looked around the net but can't find a good template or example that I could use to write the letter. Does anyone know where I can find one?

Much appreciated.

I'll be honest....in the interest of the public, if they are not willing to wait the 15 minutes, I would not administer the shot.

To me, there are certain segments on of the general population that just cannot comprehend or do not believe, that a serious reaction can happen to them and I wouldn't take very much comfort in, "Oh well, he/she signed a waiver."

The attorney would have to write the waiver to cover your state legally...if you use an online template or write it yourself, that falls under practicing law without a license and won't be worth the paper it's written on.

Up Vote Up Vote ×
Specializes in Gen Surg, Peds, family med, geriatrics.

Thank you for your replies. I didn't realize that I needed a lawyer involved. I spoke with the VP of the agency I work for and she said that we don't have any lawyers on staff. But she did say she would send me a copy of something similar to a release form for me to use as a template. Hopefully I can come up with something that is appropriate.

Thanks again for your replies.

Up Vote Up Vote ×
+ Join the Discussion