If Your Doctor Insists Vaccines Are Safe… Have This Form Signed Confirming The Safety Of Any Vaccine To Be Administered

July 22nd, 2012

FAKE NEWS for the Zionist agenda

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 __________________________

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: ______________________

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