I just updated a bunch of links. Now the forms are current.
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Showing posts with label Exemption forms. Show all posts
Showing posts with label Exemption forms. Show all posts
Friday, April 17, 2020
MessiahMews Blogs: New Exemption Forms for Various States
MessiahMews Blogs: 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. ...
I just updated a bunch of links. Now the forms are current.
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I just updated a bunch of links. Now the forms are current.
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Saturday, August 4, 2018
MessiahMews Blogs: #FuckVaccines
MessiahMews Blogs: #FuckVaccines: Pretty much sums it up... https://www.sunfrog.com/142300779-1111668197.html?8734
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Yes, and I have this and yes, I have worn it out in public. One of my chiropractors got a kick out of it. And no, I could care less what anyone thinks about it either.
We have many various politically incorrect tee shirts.
This one is the next tee shirt on the list...
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Back To the PUBLIC FOOL SYSTEM...
It's that time of the year again, for the back to indoctrination camps, and we are working on the exemption form links for VacLib and elsewhere.
What is really discouraging is that many states have adopted these incriminating forms with their deliberate trickery for wording, which is to trick fathers and mothers to admitting neglect by avoiding vaccines.
A so-called religious exemption should never have this kind of language on their forms, as people would be agreeing to false statements, which are lies. And many of them have required a notary to SWEAR these false statements. Those kind of false statements have never defined a true religious belief.
Example of one of the many false statements seen on STATE exemption / waiver forms....
This false statement is NOW on the STATE of MICHIGAN waiver form...
By signing this waiver, you acknowledge that you are placing your child and others at risk of serious illness should he or she contract a disease that could have been prevented through proper vaccination.
HELLO?! THAT was a false statement!!
True Statements:
Now, here's an example of a simple TRUE statement that lines up with a true religious belief...
http://www.anewlifehawaii.com/docs/ANL_Vaccine_Expemtion_Form.pdf
State of Hawaii Vaccine Exemption
Pursuant to:
Hawaii Administrative Rules §11-157-5
Hawaii Revised Statues §302A-1156, §302A-1157, §325-0034
I understand that all children are susceptible to diseases, even if they are vaccinated for
that particular disease. I understand that, according to the CDC vaccination does NOT provide immunity, and therefore my child could contract the disease, even if vaccinated.
Furthermore, I understand that there is significant risk involved with vaccination and that
many children have become seriously injured, sometimes resulting in death, as a direct result of the vaccination. VAERS (Vaccine Adverse Event Reporting System) was specifically created by the government to handle the large number of people that have died or received serious injury from vaccination.
I understand that some advocates of vaccination (usually ones with a vested financial interest)
report that vaccination can help prevent certain diseases. However, I do not believe the reported
benefits outweigh the confirmed danger and risks inherit with vaccination.
If at any time there is, in the opinion of the Department of Health, danger of an outbreak or epidemic from any communicable disease for which vaccination is required, this exemption from vaccination shall not be recognized. As a result, my child will NOT be vaccinated, but will be excluded from school until the threat of an epidemic is over.
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Here's another VERY SIMPLE religious statement...
I hereby certify by notarization that my conscientious or religious belief is opposed to immunizations.
Actually, the correct word would be vaccinations, as vaccination is not immunization (pdf).
But at least there is no incriminating statement.
Okay, more...
When some daycares, pre-schools, schools, colleges/universities are being a pain in the ass, and say they need additional religious statement, so some of these would be termed true religious statements. This below is on several of the Vaccination Liberation exemption pages..
"If I claim exemption for religious reasons, I will submit a statement that a particular vaccination is contrary to my religious beliefs (address listed below)..."
Good religious reasons...
These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here, attach rationale, or state why a particular vaccination is contrary to your religious beliefs, etc...
Often you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities.
Q: What constitutes a religious conflict with vaccination?
A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials.
A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities.
Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue.
A conflict arises if your religious convictions are predicated on the belief that all life is sacred. God’s commandment “Thou Shall Not Kill” applies to the practice of abortion. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from.
The Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of abortion. The acceptance of this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The Chickenpox (Varivax) vaccine containing MRC-5 and RA 273, is obtained from human babies that were electively aborted. The acceptance of this vaccine promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith.
For a child under age 18, where parent has to make the statement, concerning Hep B vaccine...
The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps my parental authority to condemn such activity in my child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith.
”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994]
“The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994]
(Indicate rationale and attach statement from clergy or other authority.)
You do not need to belong to a church or religious organization to claim religious exemption from vaccines.
Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.
Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.
-
As you can see, we are to jump through a bazillion hoops, wade through a bunch of deliberate legal BS trickery mumbo jumbo, just to say NO to vaccines. We should at least just be able to say NO and that be that.
HELL NO and #FuckVaccines !
-
-
 |
| https://www.sunfrog.com/142300779-1111668197.html?8734 |
Yes, and I have this and yes, I have worn it out in public. One of my chiropractors got a kick out of it. And no, I could care less what anyone thinks about it either.
We have many various politically incorrect tee shirts.
This one is the next tee shirt on the list...
 |
| What's in a vaccine tee shirt. https://www.etsy.com/listing/566237684/whats-in-a-vaccine-womens-t-shirt-gift |
-----
Back To the PUBLIC FOOL SYSTEM...
It's that time of the year again, for the back to indoctrination camps, and we are working on the exemption form links for VacLib and elsewhere.
What is really discouraging is that many states have adopted these incriminating forms with their deliberate trickery for wording, which is to trick fathers and mothers to admitting neglect by avoiding vaccines.
A so-called religious exemption should never have this kind of language on their forms, as people would be agreeing to false statements, which are lies. And many of them have required a notary to SWEAR these false statements. Those kind of false statements have never defined a true religious belief.
Example of one of the many false statements seen on STATE exemption / waiver forms....
This false statement is NOW on the STATE of MICHIGAN waiver form...
By signing this waiver, you acknowledge that you are placing your child and others at risk of serious illness should he or she contract a disease that could have been prevented through proper vaccination.
HELLO?! THAT was a false statement!!
True Statements:
Now, here's an example of a simple TRUE statement that lines up with a true religious belief...
http://www.anewlifehawaii.com/docs/ANL_Vaccine_Expemtion_Form.pdf
State of Hawaii Vaccine Exemption
Pursuant to:
Hawaii Administrative Rules §11-157-5
Hawaii Revised Statues §302A-1156, §302A-1157, §325-0034
I understand that all children are susceptible to diseases, even if they are vaccinated for
that particular disease. I understand that, according to the CDC vaccination does NOT provide immunity, and therefore my child could contract the disease, even if vaccinated.
Furthermore, I understand that there is significant risk involved with vaccination and that
many children have become seriously injured, sometimes resulting in death, as a direct result of the vaccination. VAERS (Vaccine Adverse Event Reporting System) was specifically created by the government to handle the large number of people that have died or received serious injury from vaccination.
I understand that some advocates of vaccination (usually ones with a vested financial interest)
report that vaccination can help prevent certain diseases. However, I do not believe the reported
benefits outweigh the confirmed danger and risks inherit with vaccination.
If at any time there is, in the opinion of the Department of Health, danger of an outbreak or epidemic from any communicable disease for which vaccination is required, this exemption from vaccination shall not be recognized. As a result, my child will NOT be vaccinated, but will be excluded from school until the threat of an epidemic is over.
 |
| Particularly this statement... In Summary, I directly forbid any and all parties, public or private, to administer any form of vaccination to my child. |
-
Here's another VERY SIMPLE religious statement...
I hereby certify by notarization that my conscientious or religious belief is opposed to immunizations.
Actually, the correct word would be vaccinations, as vaccination is not immunization (pdf).
But at least there is no incriminating statement.
Okay, more...
When some daycares, pre-schools, schools, colleges/universities are being a pain in the ass, and say they need additional religious statement, so some of these would be termed true religious statements. This below is on several of the Vaccination Liberation exemption pages..
"If I claim exemption for religious reasons, I will submit a statement that a particular vaccination is contrary to my religious beliefs (address listed below)..."
Good religious reasons...
These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here, attach rationale, or state why a particular vaccination is contrary to your religious beliefs, etc...
Often you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities.
Q: What constitutes a religious conflict with vaccination?
A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials.
A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities.
Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue.
A conflict arises if your religious convictions are predicated on the belief that all life is sacred. God’s commandment “Thou Shall Not Kill” applies to the practice of abortion. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from.
The Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of abortion. The acceptance of this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The Chickenpox (Varivax) vaccine containing MRC-5 and RA 273, is obtained from human babies that were electively aborted. The acceptance of this vaccine promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith.
For a child under age 18, where parent has to make the statement, concerning Hep B vaccine...
The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps my parental authority to condemn such activity in my child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith.
”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994]
“The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994]
(Indicate rationale and attach statement from clergy or other authority.)
You do not need to belong to a church or religious organization to claim religious exemption from vaccines.
Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.
Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.
-
As you can see, we are to jump through a bazillion hoops, wade through a bunch of deliberate legal BS trickery mumbo jumbo, just to say NO to vaccines. We should at least just be able to say NO and that be that.
HELL NO and #FuckVaccines !
-
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..
EDITED: Added South Carolina, Georgia, and Montana, and replaced TWO links from CO, which had changed since this post. Beware of that, it happens, as previously warned.
Oklahoma:
For the longest time, Oklahoma always had this crappy scanned pdf online form 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
[PDF] certificate of exemption - Epic Charter Schools
http://epiccharterschools.org/document/immunization-exemption
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. Just added more forms states and links.
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/uploaded/Community/Vaccination_affidavit_8-201541984.pdf
[PDF] Affidavit for Religious Exemption from Lead Testing Requirement
https://www.wmsde.org/uploaded/Community/lead_exemption30149.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
https://core-docs.s3.amazonaws.com/documents/asset/uploaded_file/525002/Immunization_Exemption-_Medical.pdf
MSAD 49
Fairfield - Albion - Benton - Clinton
District Medical Philosophical and Religious Immunization Exemption Form
PHILOSOPHICAL/RELIGIOUS IMMUNIZATION EXEMPTION FORM
https://core-docs.s3.amazonaws.com/documents/asset/uploaded_file/525005/Immunization_Exemption-_Philosophical_Religious.pdf
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 [DOCX]
https://sites.google.com/a/scarboroughschools.org/sps/central-office/health-services/health-services-documents/Immunizations-Exemption-Form.docx?attredirects=0&d=1
https://sites.google.com/a/scarboroughschools.org/sps/central-office/health-services/health-forms/Immunizations-Exemption-Form.docx?attredirects=0&d=1
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/hImmunization_Form.pdf?target=59cd670e-01cf-42fc-bdb7-865a4e939896
[PDF] Immunization Waiver Form - University of Maine at Augusta
https://www.uma.edu/directory/wp-content/uploads/sites/9/2017/04/Immunization-Waiver-Form.pdf
Colorado:
Immunization Non-Medical Exemption Form (Religious and Personal Belief)
https://www.colorado.gov/pacific/sites/default/files/Imm2_Non-Medical%20Exemption-English-0417.pdf
Immunization Medical Exemption Form
https://www.colorado.gov/pacific/sites/default/files/Imm_Medical-Exemption-English-0417.pdf
Other Languages Here:
https://www.colorado.gov/pacific/cdphe/vaccine-exemptions
NOTE: Colorado's forms are incriminating forms. The law allows you make your own statement.
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South Carolina:
South Carolina Certificate of Religious Exemption (From Immunization)
Religious Exemption form (DHEC form 1126)
http://www.vaclib.org/letters/DHEC-1126.pdf
http://experimentalvaccines.org/wp-content/uploads/2013/06/South-Carolina-Certificate-of-Religious-Immunization-Exemption.pdf
http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/northcarolina/south-carolina-religious-waiver.aspx
[The medical exemption] form is at the bottom of the DHEC 1148
http://www.vaclib.org/letters/DHEC-1148.PDF
http://experimentalvaccines.org/wp-content/uploads/2013/06/South-Carolina-Medical-Vaccine-Immunization-Exemption-Form.pdf
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Georgia:
VACCINATION EXEMPTION PURSUANT TO THE
OFFICIAL CODE OF GEORGIA ANNOTATED § 20-2-771
4. (e) This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages. For a child to be exempt from immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian.
ALL GA Vaccine Exemption Affidavits and forms MUST be notarized.
GA Affidavit of Religious Exemption
https://wellness-chiropractic-center.com/misc/vacaffidavit.pdf?fref=gc
* Best form, works for any school.
]DOC] Form JGC-4 - Cobb County School District
http://www.cobbk12.org/centraloffice/adminrules/J/Form_JGC-4.docx
Atlanta Public Schools:
IMMUNIZATION REQUIREMENTS:
AFFIDAVIT OF RELIGIOUS OBJECTION
https://www.atlantapublicschools.us/cms/lib/GA01000924/Centricity/Domain/74/Religious%20Objection%20Affidavit%20-%20Immunizationsv2.pdf
ExemptionVacLib-Georgia.137130643.pdf
http://www.basicchiropractic.com/yahoo_site_admin/assets/docs/ExemptionVacLib-Georgia.137130643.pdf
AFFIDAVIT OF RELIGIOUS OBJECTION TO IMMUNIZATION
http://dph.georgia.gov/document/document/affidavit-religious-objection-immunization/download
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Montana:
[PDF] Religious Exemption Form - Dphhs
AFFIDAVIT OF EXEMPTION ON RELIGIOUS GROUNDS FROM MONTANA SCHOOL IMMUNIZATION LAW AND RULES
http://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/2017/ReligiousExemptionForm2015.pdf
Note: Above link was just replaced.
Extra Backup links:
[PDF] affidavit of exemption on religious grounds - Experimental Vaccines
Web Archives:
https://web.archive.org/web/20170201153713/http://www.dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/Day%20Care/06_HES%20114%20Hib%20religious%20exemp.pdf
Archives Search:
https://web.archive.org/web/20170601000000*/http://www.dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/Day%20Care/06_HES%20114%20Hib%20religious%20exemp.pdf
BEST Medical Exemption Form because it reads the law on ME's:
HES101_2013 MT Medical Exemption Form.pdf
On Page 2 (SECTION IV EXEMPTIONS)
1. Medical: TO BE SIGNED BY A PHYSICIAN (See Section III, Health Department or Physician)
http://experimentalvaccines.org/wp-content/uploads/2013/06/Montana-Medical-Vaccine-Exemption-Form-HES-101.pdf
[PDF] Medical Exemption Form - Dphhs
Medical Exemption Statement
https://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/2017/HES101AMedicalExpemptionForm2018_11_2018.pdf?ver=2018-11-27-084721-763
Daycare:
AFFIDAVIT of EXEMPTION FROM ADMINISTRATION of
HAEMOPHILUS INFLUENZAE TYPE b (Hib) on RELIGIOUS
GROUNDS FROM MONTANA
DAYCARE IMMUNIZATION RULES
https://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/06_HES114Hibreligiousexemp_2.pdf
Experimental Vaccines Link:
http://experimentalvaccines.org/wp-content/uploads/2013/06/Montana-Hib-Religious-Vaccine-Exemption-Form-HES-114.pdf
Montana Exemption Law
http://www.shotfreeinmontana.com/montana/mtlaw2001edit.htm
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Arizona:
Beware of the language of this current form...
This...
I have been informed that by not receiving this vaccine, my child is at increased risk of developing diphtheria if exposed to this disease . Serious symptoms and effects of this disease include: heart failure, paralysis (can’t move parts of the body), breathing problems, coma, and death
can be edited to this by Crossing out the "not" and change the word "disease" to "vaccine" to read like this...
I have been informed that by receiving this vaccine, my child is at increased risk of developing diphtheria if exposed to this vaccine . Serious symptoms and effects of this vaccine include: heart failure, paralysis (can’t move parts of the body), breathing problems, coma, and death
Because the actual vaccine itself CAN and often DOES CAUSE the so-called risks of the disease, and that is proven by the Tripedia package insert. If the schools give a hard time, then attach a printed copy of the PDF Tripedia Package insert which states these adverse reactions and events.
Tripedia Package Insert Search.
Same editing applies to the Spanish form, as well.
New Incriminating Forms:
Personal Beliefs Exemption:
https://azdhs.gov/documents/preparedness/epidemiology-disease-control/immunization/school-childcare/personal-belief-exemption.pdf
Formulario de Exención por Creencias Religiosas.pef
http://azdhs.gov/documents/preparedness/epidemiology-disease-control/immunization/school-childcare/religious-belief-exemption-espanol.pdf
--
Older NON-incrimating Forms:
From the older VacLib archived pages:
https://web.archive.org/web/20090211000957/http://vaccinetruth.net/exempt/arizona.htm
Here is the list of the older NON incriminating Arizona forms. Parents can try these instead, but it may depend on the school, whether they will accept the older forms. So please try them, and also download to share with others too.
Daycare & Preschools:
REQUEST FOR EXEMPTION TO IMMUNIZATION CHILD CARE FACILITIES (English and Spanish)
(.pdf) http://www.azdhs.gov/als/forms/ccgh10.pdf
Schools:
Request for Exemption to Immunization Schools (English and Spanish)
(.pdf) http://azdhs.gov/phs/immun/pdf/school-exemption-form.pdf
Request for Exemption to Immunization - School (Spanish)
Sequoia Choice - AZ Distance Learning - Mesa, AZ. 85211-1405
(.pdf) http://scazdl.org/new/forms/waiver.pdf
ExemptionVacLib-Arizona.doc
(.doc) VaccineTruth.net/letters/ExemptionVacLib-Arizona.doc
If all else fails, and a parent is forced to sign an incriminating form, then write or sign name "Under Duress".
https://consciousawarenessforall.wordpress.com/2015/02/12/duress/
https://www.linkedin.com/pulse/how-sign-your-name-without-assuming-liability-cathy-bilsky
-----
The Truth About Vaccines (TTAV):
Register to watch FREE
Trailer Page - TTAV Re-Launch January 2018
Article - "Vaccine Schedule" - TTAV Re-Launch January 2018
Article - "Herd Immunity" - TTAV Re-Launch January 2018
Article - "Vaccines & Autism" - TTAV Re-Launch January 2018
TTAV Affiliate Signup
Vaccines Revealed:
VR Registration
VR Affiliate
-----
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..
EDITED: Added South Carolina, Georgia, and Montana, and replaced TWO links from CO, which had changed since this post. Beware of that, it happens, as previously warned.
Oklahoma:
For the longest time, Oklahoma always had this crappy scanned pdf online form 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
[PDF] certificate of exemption - Epic Charter Schools
http://epiccharterschools.org/document/immunization-exemption
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. Just added more forms states and links.
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/uploaded/Community/Vaccination_affidavit_8-201541984.pdf
[PDF] Affidavit for Religious Exemption from Lead Testing Requirement
https://www.wmsde.org/uploaded/Community/lead_exemption30149.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
https://core-docs.s3.amazonaws.com/documents/asset/uploaded_file/525002/Immunization_Exemption-_Medical.pdf
MSAD 49
Fairfield - Albion - Benton - Clinton
District Medical Philosophical and Religious Immunization Exemption Form
PHILOSOPHICAL/RELIGIOUS IMMUNIZATION EXEMPTION FORM
https://core-docs.s3.amazonaws.com/documents/asset/uploaded_file/525005/Immunization_Exemption-_Philosophical_Religious.pdf
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 [DOCX]
https://sites.google.com/a/scarboroughschools.org/sps/central-office/health-services/health-services-documents/Immunizations-Exemption-Form.docx?attredirects=0&d=1
https://sites.google.com/a/scarboroughschools.org/sps/central-office/health-services/health-forms/Immunizations-Exemption-Form.docx?attredirects=0&d=1
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/hImmunization_Form.pdf?target=59cd670e-01cf-42fc-bdb7-865a4e939896
[PDF] Immunization Waiver Form - University of Maine at Augusta
https://www.uma.edu/directory/wp-content/uploads/sites/9/2017/04/Immunization-Waiver-Form.pdf
Colorado:
Immunization Non-Medical Exemption Form (Religious and Personal Belief)
https://www.colorado.gov/pacific/sites/default/files/Imm2_Non-Medical%20Exemption-English-0417.pdf
Immunization Medical Exemption Form
https://www.colorado.gov/pacific/sites/default/files/Imm_Medical-Exemption-English-0417.pdf
Other Languages Here:
https://www.colorado.gov/pacific/cdphe/vaccine-exemptions
-----
South Carolina:
South Carolina Certificate of Religious Exemption (From Immunization)
Religious Exemption form (DHEC form 1126)
http://www.vaclib.org/letters/DHEC-1126.pdf
http://experimentalvaccines.org/wp-content/uploads/2013/06/South-Carolina-Certificate-of-Religious-Immunization-Exemption.pdf
http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/northcarolina/south-carolina-religious-waiver.aspx
[The medical exemption] form is at the bottom of the DHEC 1148
http://www.vaclib.org/letters/DHEC-1148.PDF
http://experimentalvaccines.org/wp-content/uploads/2013/06/South-Carolina-Medical-Vaccine-Immunization-Exemption-Form.pdf
-----
Georgia:
VACCINATION EXEMPTION PURSUANT TO THE
OFFICIAL CODE OF GEORGIA ANNOTATED § 20-2-771
4. (e) This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages. For a child to be exempt from immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian.
ALL GA Vaccine Exemption Affidavits and forms MUST be notarized.
GA Affidavit of Religious Exemption
https://wellness-chiropractic-center.com/misc/vacaffidavit.pdf?fref=gc
* Best form, works for any school.
]DOC] Form JGC-4 - Cobb County School District
http://www.cobbk12.org/centraloffice/adminrules/J/Form_JGC-4.docx
Atlanta Public Schools:
IMMUNIZATION REQUIREMENTS:
AFFIDAVIT OF RELIGIOUS OBJECTION
https://www.atlantapublicschools.us/cms/lib/GA01000924/Centricity/Domain/74/Religious%20Objection%20Affidavit%20-%20Immunizationsv2.pdf
ExemptionVacLib-Georgia.137130643.pdf
http://www.basicchiropractic.com/yahoo_site_admin/assets/docs/ExemptionVacLib-Georgia.137130643.pdf
AFFIDAVIT OF RELIGIOUS OBJECTION TO IMMUNIZATION
http://dph.georgia.gov/document/document/affidavit-religious-objection-immunization/download
-----
Montana:
[PDF] Religious Exemption Form - Dphhs
AFFIDAVIT OF EXEMPTION ON RELIGIOUS GROUNDS FROM MONTANA SCHOOL IMMUNIZATION LAW AND RULES
http://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/2017/ReligiousExemptionForm2015.pdf
Note: Above link was just replaced.
Extra Backup links:
[PDF] affidavit of exemption on religious grounds - Experimental Vaccines
Web Archives:
https://web.archive.org/web/20170201153713/http://www.dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/Day%20Care/06_HES%20114%20Hib%20religious%20exemp.pdf
Archives Search:
https://web.archive.org/web/20170601000000*/http://www.dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/Day%20Care/06_HES%20114%20Hib%20religious%20exemp.pdf
BEST Medical Exemption Form because it reads the law on ME's:
HES101_2013 MT Medical Exemption Form.pdf
On Page 2 (SECTION IV EXEMPTIONS)
1. Medical: TO BE SIGNED BY A PHYSICIAN (See Section III, Health Department or Physician)
http://experimentalvaccines.org/wp-content/uploads/2013/06/Montana-Medical-Vaccine-Exemption-Form-HES-101.pdf
[PDF] Medical Exemption Form - Dphhs
Medical Exemption Statement
https://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/2017/HES101AMedicalExpemptionForm2018_11_2018.pdf?ver=2018-11-27-084721-763
Daycare:
AFFIDAVIT of EXEMPTION FROM ADMINISTRATION of
HAEMOPHILUS INFLUENZAE TYPE b (Hib) on RELIGIOUS
GROUNDS FROM MONTANA
DAYCARE IMMUNIZATION RULES
https://dphhs.mt.gov/Portals/85/publichealth/documents/Immunization/06_HES114Hibreligiousexemp_2.pdf
Experimental Vaccines Link:
http://experimentalvaccines.org/wp-content/uploads/2013/06/Montana-Hib-Religious-Vaccine-Exemption-Form-HES-114.pdf
Montana Exemption Law
http://www.shotfreeinmontana.com/montana/mtlaw2001edit.htm
-----
Arizona:
Beware of the language of this current form...
This...
I have been informed that by not receiving this vaccine, my child is at increased risk of developing diphtheria if exposed to this disease . Serious symptoms and effects of this disease include: heart failure, paralysis (can’t move parts of the body), breathing problems, coma, and death
can be edited to this by Crossing out the "not" and change the word "disease" to "vaccine" to read like this...
I have been informed that by receiving this vaccine, my child is at increased risk of developing diphtheria if exposed to this vaccine . Serious symptoms and effects of this vaccine include: heart failure, paralysis (can’t move parts of the body), breathing problems, coma, and death
Because the actual vaccine itself CAN and often DOES CAUSE the so-called risks of the disease, and that is proven by the Tripedia package insert. If the schools give a hard time, then attach a printed copy of the PDF Tripedia Package insert which states these adverse reactions and events.
Tripedia Package Insert Search.
Same editing applies to the Spanish form, as well.
New Incriminating Forms:
Personal Beliefs Exemption:
https://azdhs.gov/documents/preparedness/epidemiology-disease-control/immunization/school-childcare/personal-belief-exemption.pdf
Formulario de Exención por Creencias Religiosas.pef
http://azdhs.gov/documents/preparedness/epidemiology-disease-control/immunization/school-childcare/religious-belief-exemption-espanol.pdf
--
Older NON-incrimating Forms:
From the older VacLib archived pages:
https://web.archive.org/web/20090211000957/http://vaccinetruth.net/exempt/arizona.htm
Here is the list of the older NON incriminating Arizona forms. Parents can try these instead, but it may depend on the school, whether they will accept the older forms. So please try them, and also download to share with others too.
Daycare & Preschools:
REQUEST FOR EXEMPTION TO IMMUNIZATION CHILD CARE FACILITIES (English and Spanish)
(.pdf) http://www.azdhs.gov/als/forms/ccgh10.pdf
Schools:
Request for Exemption to Immunization Schools (English and Spanish)
(.pdf) http://azdhs.gov/phs/immun/pdf/school-exemption-form.pdf
Request for Exemption to Immunization - School (Spanish)
Sequoia Choice - AZ Distance Learning - Mesa, AZ. 85211-1405
(.pdf) http://scazdl.org/new/forms/waiver.pdf
ExemptionVacLib-Arizona.doc
(.doc) VaccineTruth.net/letters/ExemptionVacLib-Arizona.doc
If all else fails, and a parent is forced to sign an incriminating form, then write or sign name "Under Duress".
https://consciousawarenessforall.wordpress.com/2015/02/12/duress/
https://www.linkedin.com/pulse/how-sign-your-name-without-assuming-liability-cathy-bilsky
-----
The Truth About Vaccines (TTAV):
Register to watch FREE
Trailer Page - TTAV Re-Launch January 2018
Article - "Vaccine Schedule" - TTAV Re-Launch January 2018
Article - "Herd Immunity" - TTAV Re-Launch January 2018
Article - "Vaccines & Autism" - TTAV Re-Launch January 2018
TTAV Affiliate Signup
Vaccines Revealed:
VR Registration
VR Affiliate
-----
Sunday, February 26, 2017
Colorado Exemption Form Action Plan
States across the US are slowly but surely forcing incriminating vaccine exemption forms. So BEWARE of what you sign.
Instructions on how to handle the Colorado exemptions.
http://www.ccfvc.org/rarely-asked-questions.html
https://www.ccfvc.org/colorado-exemption-law/
Download/print copies of the WAPF Exemption Form and Silberman’s letter and attach to the CDPHE. These are the best options:
https://ccfvc.org/cdphe/Colorado-Vaccine-WAPF-Exemption-Statement-1.pdf
https://ccfvc.org/cdphe/PhilSilbermanLetter.pdf
----------
Instructions on how to handle the Colorado exemptions.
http://www.ccfvc.org/rarely-asked-questions.html
https://www.ccfvc.org/colorado-exemption-law/
Download/print copies of the WAPF Exemption Form and Silberman’s letter and attach to the CDPHE. These are the best options:
https://ccfvc.org/cdphe/Colorado-Vaccine-WAPF-Exemption-Statement-1.pdf
https://ccfvc.org/cdphe/PhilSilbermanLetter.pdf
----------
Sunday, August 18, 2013
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