For Massachusetts...
[DOC] AFFIDAVIT
AFFIDAVIT-for-Massachusetts-Adult-college.doc
http://www.vaclib.org/letters/AFFIDAVIT-for-Massachusetts-Adult-college.doc
http://vaccinetruth.net/letters/AFFIDAVIT-for-Massachusetts-Adult-college.doc
* Could be edited to use for employment situations.
[DOC] AFFIDAVIT
AFFIDAVIT for Massachusetts Older Child.doc
http://www.vaclib.org/letters/AFFIDAVIT%20for%20Massachusetts%20Older%20Child.doc
http://vaccinetruth.net/letters/AFFIDAVIT%20for%20Massachusetts%20Older%20Child.doc
[PDF ]Religious Exemption Sign Off - Chelmsford Public Schools
Religious Exemption from Immunization Requirements
Chelmsford Public Schools
https://www.chelmsford.k12.ma.us/site/handlers/filedownload.ashx?moduleinstanceid=2635&dataid=2184&FileName=Religious%20Exemption%20Sign%20Off.pdf
And this one from one of my earlier posts...
MessiahMews Blogs: VACCINE - PERSONALIZED Religious Exemption with scriptural support...: Cleaned it up as well as I could... for Massachusetts... https://docs.google.com/document/d/1l3Uh3G37EM5RMVrP3jWy1b3vRstEJt4mgxMYkZ9FT3U/mobilebasic...
VACCINE - PERSONALIZED Religious Exemption with scriptural support
https://messiahmews.blogspot.com/2017/09/vaccine-personalized-religious.html
Vaccination Exemption Certificate
From this page:
http://www.moresureword.com/Pestilence.htm
Read----Psalm 91 & Psalm 46 that is the way we will go. Under NO circumstances will we take vaccinations government enforced or otherwise. Research vaccines before you would consider taking them. Most are dangerous. We will take Vitamin C and Colloidal Silver and TRUST The Lord.
For Me and My House
We will NOT receive the Vaccination.
We Have Valid FAITH and/or Religious
VACCINATION EXEMPTION.
With the Exemption not even the State of Massachusetts
can FORCE the Vaccine upon us.
Full sized graphic:
http://www.moresureword.com/Pestil3.jpg
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VACCINE - PERSONALIZED Religious Exemption with scriptural support.docx
http://vaclib.org/docs/Exemption-with-scriptural-support.docx
Sample religious exemption letters for MA schools - Mothering Forums
http://www.mothering.com/forum/83-connecticut-massachusetts-rhode-island/1182604-sample-religious-exemption-letters-ma-schools.html
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Notice of Religious Exemption to Vaccinations
NAME, SCHOOL
As per General Laws of Massachusetts chapter 76, section 15C (Vaccination and Immunization; Exceptions by Reason of Physical Condition or Religious Belief) I am exempting myself from vaccination because it conflicts with my sincerely held religious belief.
_________________________________
NameDate
M.G.L. c. 76, ss 15C;
§ 15. Vaccination and Immunization; Exceptions by Reason of Physical Condition or Religious Belief.
No child shall, except as hereinafter provided, be admitted to school except upon presentation of a physician's certificate that the child has been successfully immunized against diphtheria, pertussis, tetanus, measles and poliomyelitis and such other communicable diseases as may be specified from time to time by the department of public health.
A child shall be admitted to school upon certification by a physician that he has personally examined such child and that in his opinion the physical condition of the child is such that his health would be endangered by such vaccination or by any of such immunizations. Such certification shall be submitted at the beginning of each school year to the physician in charge of the school health program. If the physician in charge of the school health program does not agree with the opinion of the child's physician, the matter shall be referred to the department of public health, whose decision will be final.
In the absence of an emergency or epidemic of disease declared by the department of public health, no child whose parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs shall be required to present said physician's certificate in order to be admitted to school.
105 CMR 220.600 (2007)
220.600: Immunization Requirements for Postsecondary Students
(A) No student, as specified in 105 CMR 220.400(C) and 220.600(B), shall attend a postsecondary institution without a certification of immunization, as specified in 105 CMR 220.600(C). For purposes of 105 CMR 220.600, "postsecondary institution" shall mean a college, university, institute or school accredited as a postsecondary institution by the New England Association of Schools and Colleges.
(B) The following students are subject to the requirements of 105 CMR 220.600(C):
(1) full-time undergraduate and graduate students;
(2) part-time undergraduate and graduate students in a health science program who may be in contact with patients; and
(3) beginning on January 1, 1999, any full or part-time student attending an institution of higher education in Massachusetts while on a student or other visa, including a student attending or visiting classes or programs as part of a formal academic visitation or exchange program.
(C) Each student subject to 105 CMR 220.600(B) must present a certificate of immunization that the student has received the following immunizations:
(1) at least one dose of mumps and rubella vaccine(s) given at or after 12 months of age;
(2) two doses of live measles vaccine given at least one month apart beginning at or after 12 months of age;
(3) a booster dose of Td within the last ten years;
(4) beginning on September 1, 2000, 3 doses of hepatitis B vaccine will be required for all students in a health science program who may be in contact with patients. After September 1, 2005, this requirement shall apply to all students subject to 105 CMR 220.600.
(D) The requirements of 105 CMR 220.600 shall not apply where:
(1) the student provides written documentation that he or she meets the standards for medical or religious exemption set forth in M.G.L. c. 76, ss 15C;
(2) the student provides appropriate documentation, including a copy of a school immunization record, indicating receipt of the required immunizations; or
(3) in the case of measles, mumps, rubella and hepatitis B, the student presents laboratory evidence of immunity.
(E) Whenever possible, such immunizations are to be obtained prior to enrollment or registration. However, students subject to 105 CMR 220.600 may be enrolled or registered provided that the required immunizations are obtained within 30 days of registration and provided, further, that the postsecondary institution has policies and procedures for ascertaining which students have failed to obtain the necessary immunizations within 30 days, and for taking appropriate follow up action to ensure compliance with 105 CMR 220.00.
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Daycare
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Notice of Religious Exemption to Vaccinations
To whom this may concern,
We, parents names, are exempting our child, child's name, from all vaccinations because it conflicts with our sincerely held religious belief.
IMMUNIZATION REQUIREMENTS FOR GROUP DAY CARE AND
SCHOOL AGE CHILD CARE PROGRAMS
Regulations Of The Department of Early Education and Care
102 CMR 7.00: Standards For The Licensure Or Approval Of Group Day Care And School Age Child Care Programs (7/10/97)
Section 102 CMR 7.09(5)(a) Required Medical Examinations in Group Child Care Programs
“The licensee shall require, at admission, a physician’s certificate that each child has been successfully immunized in accordance with the current Department of Public Health’s recommended schedules against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles and such other communicable diseases as may be specified from time to time by the Office. No child shall be required, under 102 CMR 7.00 to have any such immunization if his parent(s) objects thereto, in writing, on the grounds that it conflicts with their religious beliefs or if the child’s physician submits documentation that such a procedure is contraindicated.”
Sincerely,
Names of parents
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Colleges and University Forms:
Becker College
Notice of Medical/Religious Exception to Vaccination(s)
http://www.becker.edu/wp-content/uploads/2012/12/3-Becker-medical-or-religious-waiver-form.pdf
Wheaton College
PHYSICAL EXAM/IMMUNIZATION WAIVER FOR RELIGIOUS/MEDICAL REASONS
http://wheatoncollege.edu/wp-content/uploads/2010/07/WAIVER-FOR-RELIGIOUS.MEDICAL-REASONS-2016.pdf
[PDF] Immunization Exemption Form - Babson College
http://www.babson.edu/student-life/health-wellness/health-services/Documents/request-for-immunization-exemption.pdf
Vaccination Liberation:
http://www.vaclib.org/exempt/massachusetts.htm
http://vaccinetruth.net/exempt/massachusetts.htm
Some forms from Experimental Vaccines here too:
http://experimentalvaccines.org/vaccine-exemption-forms/massachusetts/
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