Vaccination Notice for Employers


This information was compiled in response to the ever growing trend of medical institutions and other corporations requiring their employees take a flu shot (or other vaccine) as a condition of their continued employment.

Click on this link to learn about what an ’employer required’ vaccination did to a nurse. Also note that the employer provided absolutely no assistance to the nurse or her family when the vaccine caused her extremely serious health problems:

The employee vaccination notice is designed to inform your employer of the conditions under which you will comply with their flu shot (or other vaccine) request. Currently, everyone manufacturing, requiring or administering vaccines has an exemption from liability should the vaccine cause illness, injury or even death. The notice informs the employer that you will comply with the vaccination request if the employer will accept the liability . . . in writing. It is extremely unlikely that any employer will agree to your condition, which is more proof that vaccines can be extremely harmful.

Before filling out and turning in this notice, employees must request the vaccine package insert (not vaccination information sheets or handouts) 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 discuss with your family. DO NOT JUST READ IT AND HAND IT BACK. Remember if you become ill or injured it will affect more than just you. The package insert could be used as evidence should you accept the vaccine and get harmed by it.

If no insert is provided, fill out and deliver the Vaccination Notice (a). If the insert is provided use the Vaccination Notice (b).


  • Download the LAWFULLY YOURS pdf guide posted at the bottom of this page (the instructions start on page 30), 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
  • Corporate entities need to be in all caps
  • The report referenced in the notice can be read here: Health Hazards of Disease Prevention
  • 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.


The notice requires little discussion. Just hand it to your employer. Politely explain that it is your written response to the employer’s vaccination request. Should you be asked where you obtained the notice, simply say from someone who shares your concern about Big Pharma’s exemption from liability. 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.

Save a copy of the notice for your personal files and write the name of the ‘agent’ (employee) who received it and the date it was delivered.

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


5 responses to “Vaccination Notice for Employers

  1. So-called “vaccinations” are lawfully a bodily ASSAULT on your person ! Even the hint of this forced “vaccination” (really a deadly military bio-weapon experiment using you as their lab rat) should make you sue them for attempted bodily assault ! Only a full blown Communist Dictatorship would even consider it – they have no right by God to order what poisons you need to have flowing into your blood stream and body – that is RAPE. You are being forced to be the govt’s lab rat for experimentation, and that is the bottom line ! Plus they re guilty of blackmail to lay your job on the line over it !

    Come on people ! Stand up for yourself ! Grow a backbone before they rip that out of you too !
    They do not care about your health or what you will suffer after they inject their deadly poisons into you ! They just want to USE YOU as their cash cow !


  2. Thanks for the information! Do the witnesses or notary have to sign in Red ink also? And should I write my name or kids names in CAPITAL letters?


    • No one should sign in red ink, use blue. Do not put either your name or your children’s name in all caps. ALL CAPS designates corporations.


      • Wait… in the article you say to sign in red ink and here in your comment you say to sign in blue…. I’m confused…


    • Carrie Taranova - Little Bright Feather

      Never write Your name in capital letters – that makes you THEIR PROPERTY AND A NON PERSON ! Refuse any assault on or in your body by so-called “authorities” and they usually back down if you threaten to sue them. But if not call the Sheriff to make a citizen’s arrest on them. If you stand firm, they usually will back down, but be prepared for this Communist system to try an take custody of your baby or child, best to grab your child and leave as fast as you can. WE are no longer in America here and that is the thing no one is understanding. They have stripped your rights and you need to be prepared to fight for them. Never allow anyone to take or hold your child – once they do it is likely you will never see that child again – I’ve seen too many cases like this. This is why many no longer trust hospitals to give birth anymore. Home birth is safer in many ways to give birth. An d never let anyone inject you either. This is part of the DC OWG population REDUCTION agenda.

      New info – see
      This year NEW more deadly so-called “vaccines” are out – they are geared to CULL the population and seniors are especially targeted.

      visit my twitter for lots of all kinds of info
      Little Bright Feather


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