Cdph 8262-2026

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The document outlines the process for obtaining a personal beliefs exemption from required immunizations for students in California. It includes sections for authorized health care practitioners to provide information about the benefits and risks of immunization, as well as a declaration by parents or guardians regarding their beliefs against vaccinations. The document emphasizes the importance of immunizations for public health and details the potential consequences for unimmunized students during outbreaks.

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Click ‘Get Form’ to open the cdph 8262 in the editor.
Begin by entering the student’s name, gender, and birthdate in the designated fields. Ensure accuracy as this information is crucial for identification.
In section A, select the type of authorized health care practitioner and provide their details. This section confirms that you have received necessary immunization information.
Next, in section B, check the appropriate box regarding your receipt of information or religious beliefs. Sign and date this section to validate your request.
Complete the affidavit by listing any immunizations already received and checking the boxes for exemptions requested. Ensure all required signatures are included before submission.

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2013	4.8 Satisfied (137 Votes)

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