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Click ‘Get Form’ to open the immunization exemption form in the editor.
Begin by entering your child's name and address in the designated fields. Ensure that all information is accurate to avoid any issues during processing.
In the section regarding vaccinations, check off the vaccines from which you are seeking an exemption. This includes options like measles, mumps, and rubella. Be sure to indicate whether your objections are religious or philosophical.
Provide your name as the parent or guardian, along with your contact information. This is crucial for any follow-up communication regarding your application.
Finally, sign and date the form at the bottom. Your signature confirms that you understand the risks associated with not vaccinating your child.
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Every state has laws that require children to get certain vaccines before they can go to school or daycare. Yet parents may be able to opt out of one or more vaccines for medical, religious, or personal reasons. Vaccine exemption laws vary from state to state. Some states make it easier to avoid vaccines than others.
How do you get a religious exemption for immunizations?
California removed its personal and religious exemption option in 2015. Parent/guradian must complete an online educational module to receive a non-medical exemption. Connecticut removed its religious exemption option in 2021.
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Beginning 09/01/2025, blank immunization exemption affidavit forms may be downloaded from the Department of State Health Services (DSHS) website. The option to
Reason Not Vaccinated With 3 Doses of Pertussis Vaccine. 1 = Religious Exemption. 2 = Medical Contraindication. 3 = Philosophical Exemption. 4 = Previous
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