Dh 681 form pdf 2026

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  1. Click ‘Get Form’ to open the DH 681 Form in the editor.
  2. Begin by entering the child's complete name and date of birth in the designated fields. If available, include the Florida SHOTS ID.
  3. Next, fill in the parent or guardian’s name. The Social Security number is optional but can be added if desired.
  4. Ensure that the parent or guardian signs and dates the form in the appropriate section to affirm their request for a religious exemption.
  5. Finally, obtain the county health department's stamp and signature from an authorized official, along with the date of issuance to complete the form.

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There are a number of ways that someone can prove strongly held religious beliefs that getting the vaccine would contradict. Writing a formal letter requesting exemption. Getting a close friend, family member or fellow member of the clergy to write a letter. Filling out and submitting a religious exemption request form:
A religious exemption from vaccination must be obtained from a county health department. Religious exemption is not authorized or issued by schools or physicians. Every county health department issues a standardized approved religious exemption form (DH 681).

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