This form is a sample letter in Word format covering the subject matter of the title of the form.
This form is a sample letter in Word format covering the subject matter of the title of the form.
Religious exemption requires a signed statement by the parent/guardian that vaccination conflicts with their religious tenets or practices. If the child needs documentation of a health examination for the school, it must be noted by the healthcare provider on the immunization certificate.
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.
I/we hereby assert that the immunization of this student would be contrary to the religious beliefs of this child. Therefore, this child shall be exempt from the required immunizations under New Jersey administrative Code N.J.A.C.
Pediatricians and other health care providers may decide it is in their best interest to formally document a parent's refusal to accept vaccinations/immunizations for a minor child. This form, which should not be considered a legal document without advice from a lawyer, may be used for such documentation.
There are a number of ways that someone can prove strongly held religious beliefs that getting the vaccine would contradict. Writing a formal letter requesting exemption. Getting a close friend, family member or fellow member of the clergy to write a letter. Filling out and submitting a religious exemption request form:
All states allow exemptions for medical reasons, and almost all states (except California, Mississippi and West Virginia) grant religious or philosophical exemptions for people who have sincerely held beliefs that prohibit immunizations.
Objection to vaccination was also related to: faith in divine protection and healing for Protestants, Catholics, Jewish and Muslims (10); the use of aborted fetal cells for vaccines' production among Amish and Catholic communities (including during the COVID-19 outbreak when Senior Catholic leaders from the US and ...
(4) A pupil who presents a written statement of the pupil's parent or guardian in which the parent or guardian declines to have the pupil immunized for reasons of conscience, including religious convictions, is not required to be immunized.
I, __________________________________ am requesting a religious exemption from vaccination against the disease(s) or condition(s) marked below. I understand that this exemption is allowed solely for sincerely held religious beliefs and not for political, social, or other personal views.