Form arizona immunization 2026

1. Click ‘Get Form’ to open the Arizona Immunization Exemption Form in the editor.
2. Begin by filling in your child's name and date of birth at the top of the form. This information is essential for identifying your child.
3. For each vaccine listed, place an 'X' in the box next to the disease you wish to exempt your child from. Ensure you read the associated risks carefully.
4. After marking each exemption, provide your initials and the date in the designated fields on the right side of each section. This confirms that you understand the implications of not vaccinating.
5. At the bottom of the form, sign as a parent or guardian and include today's date. This finalizes your request for exemption based on personal beliefs.

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