You want to vaccinate my child? No problem. Just sign this form.

[happyexpat]

http://preventdisease.com/news/13/08...his-Form.shtml

August 9, 2013 by DAVE MIHALOVIC
You Want To Vaccinate My Child? No Problem, Just Sign This Form


I have yet to meet a Physician that will sign this form now downloaded by hundreds of parents. The reason they won't sign is two-fold: First, they do not want to place themselves in a vulnerable position of being negligent for not providing informed consent to thousands of other parents; and second, many of them realize after their own extensive research that the risks far outweigh any benefits when it comes to vaccination.

It's been over a year since hundreds of parents have downloaded this form and there are still no reports of any signatures. Many physicians won't even look at the form while they dismiss a parent's anti-vaccination stance as ridiculous. The behavior is a clear indication of a very misinformed Physician who does not have his or her patient's best interests at heart. They are not willing to inform their patients of the risks, only the benefits they feel are acceptable. They are not open-minded to any other side of the debate except their own biased view passed down through the medical system.

Then are those Physicians who have questioned the vaccination schedules and will pursue their own research. Many of them are now awakening themselves thanks to ongoing research and pressure from parents and even other colleagues to look at other perspectives besides their own indoctrination. If you are pressured by any Physician to vaccinate, please download and print this form (and send us a Physician signed copy if possible). Assertively state to your Doctor that it is the only way you will fully informed to consider vaccination, and that an analyses of the risks and benefits will better allow you evaluate the decision.

100% of Physicians approached with this form have so far declined to sign it.

Physician’s Warranty of Vaccine Safety Form

The following form was adapted from Ken Anderson's original.

Download PDF English
Physician’s Warranty of Vaccine Safety

Download PDF Espanol
Garantia Medica para la Seguridad en las Vacunas

Download PDF Francais
Formulaire a faire signer (Vaccins)




PHYSICIAN'S WARRANTY OF VACCINE SAFETY

I (Physician’s name, degree)_______________, _____ am a physician licensed to practice medicine in the State/Province of _________. My State/Provincial license number is ___________ , and my DEA number is ____________. My medical specialty is _______________

I have a thorough understanding of the risks and benefits of all the medications that I prescribe for or administer to my patients. In the case of (Patient’s name) ______________ , age _____ , whom I have examined, I find that certain risk factors exist that justify the recommended vaccinations. The following is a list of said risk factors and the vaccinations that will protect against them:
Risk Factor __________________________
Vaccination __________________________
Risk Factor __________________________
Vaccination __________________________
Risk Factor __________________________
Vaccination __________________________

I am aware that vaccines may contain many of the following chemicals, excipients, preservatives and fillers:

* aluminum hydroxide
* aluminum phosphate
* ammonium sulfate
* amphotericin B
* animal tissues: pig blood, horse blood, rabbit brain,
* arginine hydrochloride
* dog kidney, monkey kidney,
* dibasic potassium phosphate
* chick embryo, chicken egg, duck egg
* calf (bovine) serum
* betapropiolactone
* fetal bovine serum
* formaldehyde
* formalin
* gelatin
* gentamicin sulfate
* glycerol
* human diploid cells (originating from human aborted fetal tissue)
* hydrocortisone
* hydrolized gelatin
* mercury thimerosol (thimerosal, Merthiolate(r))
* monosodium glutamate (MSG)
* monobasic potassium phosphate
* neomycin
* neomycin sulfate
* nonylphenol ethoxylate
* octylphenol ethoxylate
* octoxynol 10
* phenol red indicator
* phenoxyethanol (antifreeze)
* potassium chloride
* potassium diphosphate
* potassium monophosphate
* polymyxin B
* polysorbate 20
* polysorbate 80
* porcine (pig) pancreatic hydrolysate of casein
* residual MRC5 proteins
* sodium deoxycholate
* sorbitol
* thimerosal
* tri(n)butylphosphate,
* VERO cells, a continuous line of monkey kidney cells, and
* washed sheep red blood

and, hereby, warrant that these ingredients are safe for injection into the body of my patient. I have researched reports to the contrary, such as reports that mercury thimerosal causes severe neurological and immunological damage, and find that they are not credible.

I am aware that some vaccines have been found to have been contaminated with Simian Virus 40 (SV 40) and that SV 40 is causally linked by some researchers to non-Hodgkin’s lymphoma and mesotheliomas in humans as well as in experimental animals. I hereby warrant that the vaccines I employ in my practice do not contain SV 40 or any other live viruses. (Alternately, I hereby warrant that said SV-40 virus or other viruses pose no substantive risk to my patient.)

I hereby warrant that the vaccines I am recommending for the care of (Patient’s name) _______________ do not contain any tissue from aborted human babies (also known as "fetuses").

In order to protect my patient’s well being, I have taken the following steps to guarantee that the vaccines I will use will contain no damaging contaminants.

STEPS TAKEN: _________________________
_______________________________________
_______________________________________
_______________________________________

I have personally investigated the reports made to the VAERS (Vaccine Adverse Event Reporting System) and state that it is my professional opinion that the vaccines I am recommending are safe for administration to a child under the age of 5 years.

The bases for my opinion are itemized on Exhibit A, attached hereto, -- "Physician’s Bases for Professional Opinion of Vaccine Safety." (Please itemize each recommended vaccine separately along with the bases for arriving at the conclusion that the vaccine is safe for administration to a child under the age of 5 years.)

The professional journal articles I have relied upon in the issuance of this Physician’s Warranty of Vaccine Safety are itemized on Exhibit B , attached hereto, -- "Scientific Articles in Support of Physician’s Warranty of Vaccine Safety."

The professional journal articles that I have read which contain opinions adverse to my opinion are itemized on Exhibit C , attached hereto, -- "Scientific Articles Contrary to Physician’s Opinion of Vaccine Safety"

The reasons for my determining that the articles in Exhibit C were invalid are delineated in Attachment D , attached hereto, -- "Physician’s Reasons for Determining the Invalidity of Adverse Scientific Opinions."

Hepatitis B

I understand that 60 percent of patients who are vaccinated for Hepatitis B will lose detectable antibodies to Hepatitis B within 12 years. I understand that in 1996 only 54 cases of Hepatitis B were reported to the CDC in the 0-1 year age group. I understand that in the VAERS, there were 1,080 total reports of adverse reactions from Hepatitis B vaccine in 1996 in the 0-1 year age group, with 47 deaths reported.

I understand that 50 percent of patients who contract Hepatitis B develop no symptoms after exposure. I understand that 30 percent will develop only flu-like symptoms and will have lifetime immunity. I understand that 20 percent will develop the symptoms of the disease, but that 95 percent will fully recover and have lifetime immunity.

I understand that 5 percent of the patients who are exposed to Hepatitis B will become chronic carriers of the disease. I understand that 75 percent of the chronic carriers will live with an asymptomatic infection and that only 25 percent of the chronic carriers will develop chronic liver disease or liver cancer, 10-30 years after the acute infection. The following scientific studies have been performed to demonstrate the safety of the Hepatitis B vaccine in children under the age of 5 years.
____________________________________
____________________________________ _____________________________________

In addition to the recommended vaccinations as protections against the above cited risk factors, I have recommended other non-vaccine measures to protect the health of my patient and have enumerated said non-vaccine measures on Exhibit D , attached hereto, "Non-vaccine Measures to Protect Against Risk Factors" I am issuing this Physician’s Warranty of Vaccine Safety in my professional capacity as the attending physician to (Patient’s name) ________________________________. Regardless of the legal entity under which I normally practice medicine, I am issuing this statement in both my business and individual capacities and hereby waive any statutory, Common Law, Constitutional, UCC, international treaty, and any other legal immunities from liability lawsuits in the instant case. I issue this document of my own free will after consultation with competent legal counsel whose name is _____________________________, an attorney admitted to the Bar in the State of __________________ .
_________________________ (Name of Attending Physician)
______________________ L.S. (Signature of Attending Physician)
Signed on this _______ day of ______________ A.D. ________
Witness: _________________ Date: _____________________
Notary Public: _____________Date: ______________________




=================================================

I'm really anxious to hear back from any readers whose doctor decides to sign this document in an effort to satisfy your peace of mind. I also have a lengthy list of legal professionals who are very curious as well.

Dave Mihalovic is a Naturopathic Doctor who specializes in vaccine research, cancer prevention and a natural approach to treatment.

[Tesla_WTC_Solution]

Those of us with damaged and altered kids are proud of your efforts to make known the underlying causes.

Few docs know anything useful regarding what is wrong with our kids.

It's like raising little war casualties while no one acknowledges the crossfire we got hit by.

P.s. being enlisted helped me start to realize that vaccines not only can ruin lives, but DO ruin lives.

[happyexpat]

Tesla, I know just a few of your experiences from your posts... I am truly sorry for what you and your family have gone through and continue to go through.

[Mercedes]

Thank you so very much for this.

[ghostrider]

what did the tribal people do without needles ??? doctors, lawyers, pharmacys, insurance ... they were alot happier, and had more of a family and community mindset ...not to mention nature came first ...

[Shannow]

happyexpat,
thankyou, it's a great document, and I wish it was available when I was battling the medicos about why my children were NOT getting a hep B vaccination in the delivery room.

[Molly]

While I believe there is good intentions behind this, I have to say that I don't believe it would do any good. It's nowhere near the root of the problem. It's the government who forces vaccines. Instead of something like this, maybe there should be petitions made for all of us to sign. There's a thought.

[onawah]

There are petitions Molly. Lots of non-profit groups have and are circulating various anti-vaccine petitions.
If you look for them online, they're not hard to find.

[Molly]

Posted by onawah (here)
There are petitions Molly. Lots of non-profit groups have and are circulating various anti-vaccine petitions.
If you look for them online, they're not hard to find.

Awesome. I'm going to hit the 'thanks' on that one & google it up. Not thanks hit for the waste of time originally posted.

[Molly]

good start here:
http://www.care2.com/find/site#r=petitions&q=vaccine

[happyexpat]

Posted by Molly (here)
Awesome. I'm going to hit the 'thanks' on that one & google it up. Not thanks hit for the waste of time originally posted.

It's not a waste of time if it gets anyone (especially a doctor giving vaccinations) to think about what they are doing, and there's no call whatsoever for rudeness.

[Nanoo Nanoo]

the only way to change this is boycott doctors all together. Once the money supply starts to dry up they will pay attention.

N
N

[danceblackcatdance]

if a vaccine negatively impacts on someone over what timeframe would you see the effects? just curious... could it affect them as late as in their early 20's say?

[Violet]

Posted by ghostrider (here)
what did the tribal people do without needles ??? doctors, lawyers, pharmacys, insurance ... they were alot happier, and had more of a family and community mindset ...not to mention nature came first ...

There's a point in that. The only problem might be that bacteria, viruses are intelligent and change as a reaction to certain environments. After a long vaccination culture is it still possible to go back to the era before that and expect the same "harmless" bacteria? Or have we ourselves bred monsterbacteria and viruses that we can no longer fight with our own immune systems? Who'll tell.

Other than that, the form is too long, even for a doctor. Such weighty things should be brief, clear and precise. I like the way roles are being turned around though.

[Christine]

Hi danceblackcatdance,

I haven't seen you around much lately... my warmest wishes that you are well. Your question on when a vaccine impacts someone negatively and when would effects be visible is a good one.

I have spent over thirty years now in revolt to the vaccine scheme (as in underhanded slight of hand) and would like to spent a few minutes answering your questions.

Short answer is it depends. First in my opinion a vaccine always impacts a persons body negatively.. how much of an impact depends on many things: The general health and immune system of the person innocolated, the age of the person (babies and the elderly are the most impacted), how many other vacccines have then been exposed to, were they sick at the time the vaccine was administered, etc.

For some people the effects are immediate and range in severity from irritability and fever to full blown autism to death. For others it is harder to correlate the vaccine damage with the illness or deterioration of health. Vaccines have an accumulative effect of slowly poisoning the body with toxins such as mercury and other foreign substances while diminishing the Natural Immunological responses. A doubly nefarious cocktail.

If you or your child has had side effects from vaccines please do not vaccinate further.. I believe the risk for severe reactions increases with each vaccine.

If for some reason you have to vaccinate yourself or child, please take extra care. This is from naturalnews. com:

One hour before vaccination: Take yourself or administer to your child or pet a dose of a powerful Omega 3 supplement, preferably one that is from an alternative source of marine lipids, to fish oil, such as New Zealand, greenlip mussel oil. This bi-valve mollusk is known to be a rich source of 33 essential fatty acids; 18 of which are Omega 3. The best scenario would be an Omega 3, marine lipid, that is cold-extracted and certified to be free of mercury and pollutants. If the product contains antioxidants with a high ORAC value, and/or is used as its natural preservative, all the better.?Sources for quality greenlip mussel supplements are available online.

Continue with the Omega 3, marine lipid, supplementation regularly to prevent inflammatory flare ups, which may occur at any time.?

Take a dose of additional antioxidants, such as curcumin and quercetin in particular, because they have been found to block the ability of vaccine adjuvants to trigger a long-term immune reaction.

Immediately before vaccination (or as close as possible): Take a calcium supplement. It needs to contact the mucous membranes of the mouth, so hold it under your tongue or give to pets by mouth; even a tiny bit of a calcium tablet will work.

After an injectable vaccination: Apply a cold or ice pack to the injection site. This will inhibit blood flow to the area and keep the vaccine ingredients from spreading into the blood and surrounding tissues. This is especially important for vaccines that contain adjuvants. Take your own pack with you, as the nurse or doctor will look at you as if you are insane, and we want it applied immediately.

Take a dose of homeopathic Thuja Occidentalis 30C, immediately after vaccination (or at least within 2 hours), and then every 12 hours for a total of 3 doses (more is not necessary and may negate the benefits). Homeopathy is able to head off many adverse vaccine effects, including those that may appear months or many years later. Thuja is available at health food stores that carry homeopathic remedies, compounding pharmacies, and several excellent homeopathic sources can be found online.

Learn more: http://www.naturalnews.com/032787_va...#ixzz2dpg1cCih

Posted by danceblackcatdance (here)
if a vaccine negatively impacts on someone over what timeframe would you see the effects? just curious... could it affect them as late as in their early 20's say?

[Shamz]

My wife works at Duke hospital -NC - in their Corporate finance Dept. This year Duke has made it mandatory for all employees to take FLU shot or face termination. Only exception will be a letter from Doc stating why you don't need it or any religious reason supported by documentation.

What the heck we are supposed to do ? My wife has never taken FLU shot in her life..neither did I .. but this is beyond crazy.

any thoughts ?

[onawah]

I can't remember the name of it now, but there is (or at least, used to be) a church that would ordain you as a minister, send you a certificate, etc. for a fee.
I think if you are an ordained minister, you can provide your own religious reason.
Or you can find a church in your area who will help; just do an online search for churches in your area who are sympathetic.
You can contact the NVIC for help and advice at http://www.nvic.org/
One of their main goals is helping people with this kind of issue.
Good luck!

[Violet]

Posted by Shamz (here)
My wife works at Duke hospital -NC - in their Corporate finance Dept. This year Duke has made it mandatory for all employees to take FLU shot or face termination. Only exception will be a letter from Doc stating why you don't need it or any religious reason supported by documentation.

What the heck we are supposed to do ? My wife has never taken FLU shot in her life..neither did I .. but this is beyond crazy.

any thoughts ?

I've heard of a similar something in Europe, just can't exactly recall when & where.

But it's a very silly way of presenting a measure because nobody wants to get fired so everybody's going to a) bend or b) lie.

Please do let us know afterwards if anyone resigned themselves because of this measure, that would really be something (which people with families can of course not afford to do in these uncertain times).

Meanwhile, best of luck.

[Violet]

Okay, I found it already. The university research paper is by a doctor and in Dutch but I'll add the link anyway for reference. It looks like the situation in the US is used as a role model. Here are some highlights:

- have 75% of all health personnel vaccinated (flu shot) by 2014-2015 (recommendations)

- Overview vaccination of US health workers:

• Influenza (2006-2007): 46.7%

• HBV (3+doses): 61.7%

• Tetanus (last 10 years): 70.4%

- p.10 actually states that cost-effectiveness of Influenza shot is doubtful. (remember this is a University Research Paper)

- Last page sums up "Issues" and among them are both the mixed feelings of healt workers and the question of obliging the shot. And if so (obliged), "accompanying measures will definitely be necessary", whatever that means.


And a chart:

[IMG][/IMG]

[onawah]

Here's the church I mentioned in Post #17, the Universal Life Church
See:
http://www.themonastery.org/ordination
although re vaccines, it says:

Congregations as new organizations – Ministries or Churches, may set their own policies and practices within the law. (One example provided: immunization waivers.)
Ministers with or without congregations should understand that the Mother Church does not get involved in issues such as “vaccinations,” which is a common issue. All such issues are local issues. The Universal Life Church Monastery will not issue directives allowing individuals or children to not be vaccinated as a religious belief. Many times by letter or phone this issue approaches us.

Local congregations, being sovereign, do have that right, but they do not have a right to compel others to do their will or be at increased risk of contagion. If individuals have a congregation, that organization can issue its own directive. We are not aware of any such home church issuing a successful directive against the immunization of either children or adults.

So you would probably be better off finding a local church that will support you in the vaccine issue.