People for Life and Freedom

Form for Employees Whose Employers Are Requiring Covid-19 Injections

NOTE TO EMPLOYEE: Be sure to document the date and time you submit this form to your employer; also document the date and time and their response if they refuse to sign it.

NOTE TO EMPLOYER: As your employee, I am requesting that you review this document, provide the requisite information, and sign the form, in regards to your requirement that employees get a Covid-19 emergency use authorization (EUA) investigational vaccine.

1) If I agree to receive an EUA Covid-19 injection, does my employee health insurance plan provide complete coverage should I experience an adverse event, or even death? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2) As an employee, does my life insurance policy provide any coverage in the event that I die from receiving an EUA Covid-19 injection?  ( the above statements are only an excerpt)

READ AND PRINT FULL DOCUMENT HERE