Immunization waiver form 2026

1. Click ‘Get Form’ to open the immunization waiver form in the editor.
2. Begin by entering your child's full name and birth date in the designated fields. This information is crucial for identifying the child associated with the waiver.
3. In the section listing vaccine-preventable diseases, check all applicable boxes for which you are requesting an exemption. Ensure that you only select those vaccines you wish to object to.
4. Provide a written statement indicating your religious or philosophical objections in the 'Reason' section. Be clear and concise to ensure your intentions are understood.
5. Fill in your name as the parent or guardian, along with your contact telephone number and address. If your child's address differs from yours, include that information as well.
6. Finally, sign and date the form at the bottom. This signature confirms your understanding of the risks involved with not vaccinating.
7. Once completed, save your document and distribute it as required, ensuring a copy is sent to your local health department.

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