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Thursday, March 23, 2017

New Exemption Forms for Various States

Every now and then, I'll go on a search spree, and find updated and/or new exemption forms online.

These are to share with Vac Lib to put on the exemption pages there, and also to share with Kenny Valenzuela for his exemption pages at Experimental Vaccines site.

So as I find them, going to start sharing here as well.  Only getting the NON incriminating ones.

Share these widely, and even better yet, DOWNLOAD them to your computers, in case they disappear.  Sometimes links change, forms are pulled offline, etc..





Oklahoma:

For the longest time, Oklahoma always had this crappy scanned pdf online from various sites and we have always wanted a good original one.  Well, I finally found the original that the state had finally put up on their website.

[PDF] certificate of exemption - State of Oklahoma
https://www.ok.gov/health2/documents/IMM_School_ODH_216a_Certificate_of_Exemption.pdf


I also have current updated links for Maine and Delaware...  I've been making groups for each state and adding the non incriminating files in the files section of each state's group.

Delaware:

http://delcode.delaware.gov/title14/c001/sc02/index.shtml#P227_51758
http://vaccines.procon.org/sourcefiles/delaware_vaccine_law.pdf

Exemptions:  Statute 14: 131 (no date available) allows exemption from immunization requirements under the following circumstances: (1) Presentation of a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that the student should not receive the prescribed immunizations because of the reasonable certainty of a reaction detrimental to that person (history of clinical illness of measles or rubella not acceptable as cause for exemption), or (2) Presentation of a notarized Affidavit of Religious Belief (outlined in statute) that states that the parents or legal guardians of the student reject the concept of immunization because of individual religious beliefs.  In the case of a vaccine preventable epidemic, any child enrolled in school who is exempt from the immunization program shall be temporarily excused from attendance at public school.

AFFIDAVIT OF RELIGIOUS BELIEF
STATE OF DELAWARE

[PDF] affidavit of religious belief - State of Delaware
http://www.dhss.delaware.gov/dph/hsp/files/olpprelexempt.pdf

[PDF] Notarized Affidavit of Religious Belief
http://www.doe.k12.de.us/cms/lib09/DE01922744/Centricity/Domain/150/Immunization%20-%20Notarized%20Affidavit%20of%20Religious%20Belief.pdf

[PDF] Affidavit for Religious Exemption from Vaccination Requirement
https://www.wmsde.org/Customized/Uploads/ByDate/2016/April_2016/April_8th_2016/Vaccination%20affidavit%208-201541984.pdf

[PDF] Affidavit for Religious Exemption from Lead Testing Requirement
https://www.wmsde.org/Customized/Uploads/ByDate/2015/January_2015/January_26th_2015/lead%20exemption30149.pdf

[PDF] Delaware Religious Belief Affidavit Vaccine Exemption Form
http://experimentalvaccines.org/wp-content/uploads/2013/05/Delaware-Religious-Belief-Affidavit-Vaccine-Exemption-Form.pdf

[PDF] Immunization - School Vaccination Medical Exemption Form
http://www.doe.k12.de.us/cms/lib09/DE01922744/Centricity/Domain/150/Immunization%20-%20School%20Vaccination%20Medical%20Exemption%20Form.pdf

[PDF] University of Delaware Immunization and History Form
http://www.brandywinepediatrics.com/admin/uploads/UDImmunizationInformationFormpdf.pdf


Maine:

Maine Religious and Philosophical Belief Exemption Form
IMMUNIZATION EXEMPTION FORM
http://experimentalvaccines.org/wp-content/uploads/2013/06/Maine-Religious-and-Philosophical-Belief-Exemption-Form.pdf


Maine Regional School Unit 21
Arundel, Kennebunk, Kennebunkport , Maine
Immunization Exemption Form
http://experimentalvaccines.org/wp-content/uploads/2013/06/Maine-Regional-School-Unit-21-Immunization-Exemption-Form.pdf


RSU No. 5
Durham – Freeport - Pownal
Maine Immunization Exemption
http://www.rsu5.org/userfiles/-4/my%20files/exemption%20formfinal.pdf?id=173


MSAD 49
Fairfield - Albion - Benton - Clinton
District Medical Immunization Exemption Form
MEDICAL IMMUNIZATION EXEMPTION FORM
http://www.msad49.org/UserFiles/Servers/Server_3012026/Image/Health%20Services/District%20Medical%20Immunization%20Exemption%20Form.pdf

MSAD 49
Fairfield - Albion - Benton - Clinton
District Medical Philosophical and Religious Immunization Exemption Form
PHILOSOPHICAL/RELIGIOUS IMMUNIZATION EXEMPTION FORM
http://www.msad49.org/health_services/immunizations/district_medical_philosophical_and_religious_immunization_exemption_form/


SCARBOROUGH SCHOOL DEPARTMENT
P. O. BOX 370
SCARBORUGH, ME 04074
IMMUNIZATION EXEMPTION FORM
An annual signed exemption due to religious or philosophical reasons
Exemption Form [PDF]
https://db0aae9c-a-471900dc-s-sites.googlegroups.com/a/scarboroughschools.org/sps/central-office/health-services/health-forms/Immunization-Exemption-Form.pdf?attachauth=ANoY7crIVbKlJIQZ2MdbSEhLszPLGdbyCZKAbwGhrjEa4JO1NDmD7o1at2KbP0BWL3IpDiTV77UgY44fLlL8IdJXagsZCh37BJGg1jn0yyqyjR4pvH3HAmo0xpgv_SS0RVQ_XZRbQ6kC7PkZEE1yccyJCYLTHOKccnZbJP3aKwS9v813K8QYuJj0qdrYFcwd64uFv9AQ2PbBf7N3yBUhDdHe3mWo_CrWL3Q3Q06tez2Cl0yriwTSJZKGLOxXnAQBAho3V041jfB8rrYa4cXi4-JK5x8UX22uCbOk_F6XtJN4_VkCwtCS_Mk%3D&attredirects=0


University of Southern Maine
If you have not been vaccinated and therefore can not provide proof of immunizations due to moral, political or religious beliefs.
In this case, you may download our "Objection Letter" and submit that in place of the records.
https://usm.maine.edu/sites/default/files/University%20Health%20and%20Counseling%20Services/Objection%20letter.pdf


University of Maine at Augusta Vaccine Waiver Form
http://experimentalvaccines.org/wp-content/uploads/2013/06/University-of-Maine-at-Augusta-Vaccine-Waiver-Form.pdf


[DOC] My SMCC - Southern Maine Community College
*WAIVER SECTION* Page 2
https://my.smccme.edu/ICS/icsfs/Immunization_Verification_Waiver_2015.doc?target=306d0fd3-d80d-4d01-9304-1fb503e3ae2e

[PDF] Immunization Waiver Form - University of Maine at Augusta
http://uma.edu/assets/docs/registrar/immunizationwaiver.pdf


Colorado:

Immunization Non-Medical Exemption Form (Religious and Personal Belief)
https://www.colorado.gov/pacific/sites/default/files/Imm2_Non-Medical-Exemption-English.pdf

Immunization Medical Exemption Form
https://www.colorado.gov/pacific/sites/default/files/Imm2_Medical-Exemption-English.pdf

Other Languages Here:
https://www.colorado.gov/pacific/cdphe/vaccine-exemptions


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