If a doctor wants you or your children to have a vaccine ask them to sign this

If a doctor wants you or your children to have a vaccine ask them to sign this-

Thought this would be useful couldn't see it anywhere else, great for keeping in your kids school bag.

Thanks to David Icke, (don't know about reptiles but hes been bang on the money with most everything else)


Physician's Warranty of Vaccine Safety

I (Physician's name, degree)_________________________, _____ am a physician licensed to practice medicine in the State of ________________. My State 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 ___________________________________________
Risk Factor ____________________________________________
Vaccination ___________________________________________
Risk Factor ____________________________________________
Vaccination ___________________________________________
Risk Factor ____________________________________________
Vaccination ___________________________________________

I am aware that vaccines typically contain many of the following fillers:

* aluminum hydroxide
* aluminum phosphate
* ammonium sulfate
* amphotericin B
* animal tissues: pig blood, horse blood, rabbit brain,
* dog kidney, monkey kidney,
* chick embryo, chicken egg, duck egg
* calf (bovine) serum
* betapropiolactone
* fetal bovine serum
* formaldehyde
* formalin
* gelatin
* glycerol
* human diploid cells (originating from human aborted fetal tissue)
* hydrolized gelatin
* mercury thimerosol (thimerosal, Merthiolate(r))
* monosodium glutamate (MSG)
* neomycin


Complete printable PDF version -
www.davidicke.com...

[edit on 15-11-2009 by moocowman]

Well, somebody should have to sign something if they want me to ever get the poke which I will always refuse. If they wont take accountability for their 'safe' vaccine', then why in the world would anybody make that kind of risk. Novartis(sp) Baxter, Glaxal and what have you.. should be liable and how they made themselves exempt from accountability is distrusting and unethical.

Hmmmm.... I saw that's the work of David Icke judging by that link... Is there a better source for the same or a similar form? Don't get me wrong, he's a very... erm interesting person - But you gotta remember you have to keep a straight face while getting a medical professional (who does have the power to have to assessed for mental conditions ) to sign that...

Also that seems to be for the US guys, if there is a UK version I'd be interested - remember it's not just the americanisms that will be different - medical terms do vary also.

reply to post by Now_Then


For sure. I copied and edited this form to seem less strange like taking the dog kidney and monkey kidney out for example.

None the less, its a good idea.

Edit:

I also took anything that wasn't related to the h1n1 vaccine such as the hep c shot out of the copy.

[edit on 15-11-2009 by disfugured]

Great post maybe this would make more doctors ask more questions. Like the question now that the h1n1 flu has transfered to cats will the vaccine still work?Has the bug mutated?Questions like that.

reply to post by Now_Then

Also that seems to be for the US guys, if there is a UK version I'd be interested - remember it's not just the americanisms that will be different - medical terms do vary also.

As the previous poster mentioned it's easy to edit to suit the UK.

I think you somewhat trivialize the possible importance of this form, especially in relation to our children.

Example , sequence of events -
Of recent in the UK lots of MSM attention given to cervical cancer, eg the Jade Goody case and a nation of bleeding hearts.


This was then followed by a great deal of MSM coverage in relation to a new vaccine.

A great deal of discussion took place in my daughters school (and thousands others) in relation to the new wonder drug.

A letter was sent out to parents from the school in relation to the benefit of having the vaccine asking permission to inoculate.

The child already primed through fear mongering (bearing in mind this is a school that conducts biometric fingerprinting of children "without" consent) gives letter to mum to sign.
Mum signs without any hesitation , child receives vaccine.

So far I've yet to meet but one father who was consulted upon this scared women just signed the dotted line.

I myself was not consulted and I told my daughter that she was not to have it yet until I learned what the hell was going on, just wait a while.

Needless to say the ex way got her jabbed immediately and flipped me a finger.

Within days the MSM were reporting illnesses following the vaccines being administered.

To late damage done and my child is terrified.

At this point whether or not the vaccine was safe is not the issue, the point I'm trying to make is this -

If my child had some sort of document as the one in question upon her person, demanding the administrator of the vaccines to sign. Maybe the doctors and nurses would do their homework before sticking someone else child.

If doctors were given this type of form before administering thalidomide for example I suspect we may have had a few less victims of that drug.

Apologies in advance if your not trivializing, however , we currently live in a society where school kids carry condoms with them surely it's smart to have a little extra protection in situations when they could have to make a different type of very adult decision?

reply to post by moocowman


Yhea I see your point entirely - I suppose to make my feelings clear on that particular version of this type of form...

1) I'm not medically trained (although I try my best to understand what I can) and

2) That form, while maybe not exactly Mr David Icke's work is from his site... Now this guy is far too on the edge for me to take seriously on this issue (pretty much most others - that really my personal feelings there)... This issue has many many professional Doctors and other medical professionals who are listing their credentials along with their advice / opinion... Now these guys have their professional credibility to worry about - if I can read background on them, well why should I even consider someone who makes very sensationalist claims, and to be honest rambling and incoherent statements whenever he is intiviewed?

(I'm trying not to attack Icke here... I enjoy finding out some of his ideas... But that's really why I can't take him seriously... Just because someone is prolific shouldn't automatically make him an autroity!).

What I'm really saying is that yes a form like this is a good idea - and maybe it was drawn up by professionals and handed to him to pass on... What's the provenance of this form? Can we see similar to compare? - It's a very serious thing for some... Me I don't have children so I just have to say no my self.

Edit - I just want to cross link a couple of threads...

Alarming Info!!! Spanish Doctor Reveals Important Information About Swine Flu -

reply to post by Now_Then


IT was the "Solid Intelligent Angry Speaker" video that prompted me to post this thread, that is one hell of a scary video.

The way I look at it is this, my local GP, School and local health health authority advisers etc are very unlikely to be presented with the kind of info we come across on ATS etc.

MY local GP for example is likely to see a couple of hundred patients a week and openly admits to not being specialized in anything which I'm not condemning.

He is presented with information in relation to some new vaccine produced in the US, but as we can see even the health "experts" in the US don't seem to be able to get to the truth.

By presenting the "Individual" who is about to inoculate my child with a form asking him to be accountable for his actions the individual may be a little more responsible and investigate .

The overwhelming impression I get, is that people such as yourself and members of ATS etc do a lot more research and ask harder questions than many health professionals.

To my mind we must always take people to task when in doubt, if we do we are far less likely to hear the words "He told me it was safe so it's nothing to do withe me" .

My wife's friend is a community nurse and has just received a batch of flu vaccine which is in powder form and she has to mix it with a dilutant of some kind, I thought this odd as I thought the vaccines were supplied ready to administer. She mentioned that there was little instructions with the delivery and that the Doctor was a little dismissive when questioned about the requirement of consent forms saying that the normal flu ones would do..

My wife spoke of some of the things that I have been reading on here and on theflucase site and her nurse friend took the high ground and called my paranoid

Maybe so but I'd rather read as much as I can and try to take a reasoned view on things than just obey orders..

reply to post by badBERTHA

My wife spoke of some of the things that I have been reading on here and on theflucase site and her nurse friend took the high ground and called my paranoid

I wonder how much of the high ground the nurse friend would keep if she had to sign the consent form, maybe you could give her a copy to see if she's willing to commit her reputation to it.

IS this printable form actually legal tender? I mean, say i had a kid, and wanted to use this form here, at top of page, show it tot he doctotr...id imagine, the doctor is going to tell me it it isnt legal nor unifrom practicve for him to sign it* and doing so will refuse to do it..

reply to post by moocowman

By presenting the "Individual" who is about to inoculate my child with a form asking him to be accountable for his actions the individual may be a little more responsible and investigate .

I gave you a star for that one, friend.

Since the pharma manufacturers have been given immunity from liability, and have not properly subjected these vaccines to clinical trials other than their own (hint: they want to make money, so they will hardly veto their own drugs), and you can't sue the gov't if it makes these poisonous concoctions mandatory, it's only fair that the individual who is is administering the drug take full responsibility. I mean real responsibility: Both financial liability and legal. If they know the drug to be harmful, and they administer the drug to a person who becomes sick or dies, they should be prosecuted for endangerment or manslaughter. That'll make them think twice.

The Spanish doctor videos are incredible. In a 'good' flu year more than 40,000 people die from the virus. The MSM constantly use scare tactics like, "OVER 100 DEAD FROM SWINE FLU" to manipulate the statistics.
I'm not saying that H1N1 isn't deadly in some cases, but it's not as deadly as regular 'flu.

SOMEONE needs to take responsibility for the side effects of these drugs. Big Pharma spends billions per year in out of court settlements and lobbying as a regular business practice. They know the harm that can be done, but it's all in a days work for them.

Present the form to the Doctor and you'll be asked to leave his office as soon as he reads the form.

Why would any Doctor want to fill out a form that makes him/her responsible for any symptom that your child may display after a vaccination?

For that matter, why would any doctor want to fill out any additional paperwork ?

Whoever came up with this form gets my appreciation for a good attempt at humor.

reply to post by Wildbob77


But there's many a true word spoken in jest.

Every doctor should adhere to the Hippocratic oath. If they know the vaccine will harm people, their license should be pulled and they should be prosecuted. If they are certain that they are doing the right thing, they should have no problem with signing the form. Can't have it both ways.

All this form is asking is for the physician to be honest about what he does and does not know about what he/she is administering. If he/she claims to be ignorant of the possible adverse side affects, they shouldn't be administering it in the first place.

If the physician is compelled by law (were mandatory shots to become a reality), the Hippocratic oath would still apply. A few doctors rising up against TPTB wouldn't hurt at all.

One addition I'd possibly make to the form is a question on any gifts or payments from the vaccine manufacturer made to the physician or his/her practice. Are there any financial incentives or rewards for the physician to use this particular vaccine?

[edit on 16-11-2009 by Badgered1]

reply to post by Badgered1


Here is the cdc link that discusses Side Effects of the H1N1 vaccine.

Here is a quote.

"
What are the possible side effects of the 2009 H1N1 flu shots?
The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. The most common side effects after flu shots are mild, such as being sore and tender and/or red and swollen where the shot was given. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

Is the 2009 H1N1 flu shot expected to be associated with Guillain-Barre Syndrome (GBS)?
In 1976, an earlier type of swine flu vaccine was associated with cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS) at a rate of approximately 1 case of GBS per 100,000 persons vaccinated. Some studies done since 1976 have shown a small risk of GBS in persons who received the seasonal influenza vaccine. This risk is estimated to be no more than 1 case of GBS per 1 million persons vaccinated. Other studies have shown no increase in risk of GBS. Pregnant women should tell the person giving the shots if they have ever had GBS.

"

Perhaps the Doctor should just refer anyone interested in the H1N1 vaccine to the cdc website.

reply to post by Wildbob77

The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. The most common side effects after flu shots are mild, such as being sore and tender and/or red and swollen where the shot was given. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

"Expected to be...", "Some people might....", "they usually.....", "Sometimes...", "...are very rare...", nothing ambiguous there. Trés scientific. Do they give the data on these cases? Do they give the data on the mortality rates for regular influenza and H1N1? Do they tell you the ingredients? Hell no, that's "Proprietary" information.

Bottom line is that if there is a risk, however slight, there should be liability. If this risk is not adequately disclosed, then assumption of risk liability must be treated accordingly.

reply to post by Badgered1

One addition I'd possibly make to the form is a question on any gifts or payments from the vaccine manufacturer made to the physician or his/her practice. Are there any financial incentives or rewards for the physician to use this particular vaccine?

Good point I hadn't thought of that, here's a scenario to ponder-

Small village GPs practice population 5000 2 doctors to cover the entire population at 10 minutes per consultation.

Are we honestly to believe these GPs get enough time to do any research about the drugs they dish out ?

During lunch in pops, Jane a pharmaceutical rep young chirpy and very attractive singing the praises of her companies product, which happens to be included in a list of drugs the GP has access to.

Given that the profit margin on Prozac for example is around a mind boggling 569000 % , are we really to believe that the GPs only incentive to push the product is handful of embossed notepads with the Prozac logo ?

We live in an age of "Due Diligence" where everyone from the supermarket worker to the plumber, has to show they take reasonable precautions to protect their customers and their colleagues for fear of the courts.

Is it unreasonable to ask our health workers, from the cleaner right up to the Administrators to be equally accountable ?

reply to post by Badgered1


There are risks and benefits with almost any medicine. Should a doctor be liable for any reaction that any patient has, even if the patient has been informed about these side effects?

Should a doctor have to complete paperwork on each medication that he/she prescribes that essentially repeats the information that is contained with the medication when you get it from the pharmacy?

My children's doctor recently told me to find a new physician because I do not have my children vaccinated. She will not be their pediatrician unless I give in and vaccinate them. (She is a Kaiser Pediatrician). After speaking to many friends who also have Kaiser Insurance, I found out that this is the stance of many of their pediatricians and that it proves difficult to find one in the network (at least in our county) who isn't going to try to bully you into vaccinations at every turn.

I'd be very interested to find out if this particular doctor who told me to seek out another Pediatrician would be willing to sign this form in order for me to comply with her wishes.

There is not a single doctor out there that would sign this thing. Their legal liability is covered already, so why open themselves up for potential lawsuits and potential criminal charges? It's a nice thought...but will never happen.