[ Insert the Sender’s Address]
———- [ Address Line1] ———–
———- [ Address Line 2] ————
[ Insert the Date of sending the letter]
[ Insert the Receiver’s Name]
[ Insert the Receiver’s Address]
———- [ Address Line1] ———–
———- [ Address Line 2] ————
Dear Mr./ Mrs./ Ms. [ Insert the name of whomsoever it is concerned to]
SUB: [ Insert the subject concerned to the letter]
Greetings of the day!
The company had recently circulated notice regarding the injecting of the influenza vaccine.
This was to inform you that I understand that the vaccination is being considered for my well-being and that, through the circular, I have received, read, and understood all the benefits and the risks that are involved with this vaccine.
This letter was to inform you that, I am a patient who is suffering from [ insert the name of the concerned illness], taking a shot for influenza, could bring adverse effects on my treatment, which is my current priority.
Thus, with all of this into consideration, I have come to a decision that I would wish to decline the influenza vaccination this time due to the above-stated concerns.
I anticipate to the hope that you would understand the gravity my situation and exempt me from the vaccination this time
Thank You.
Sincere Regards,
[ Insert the Full Name of the Sender]
[ Insert the Designation], [ Insert the Name of the Organization]
[ Insert the Contact Details]
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