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Requesting a Religious Exemption An MSDH Religious Exemption Request (Form 139-R) must be completed, signed, and submitted to the County Health Department (appointment is required) by the child's parent or guardian. Appointments can be made by calling 855-767-0170.

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.

It is morally wrong to receive a vaccine that used fetal cells in the development stage—the most commonly cited religious objection to the vaccines; The body is a temple that should not receive foreign or unnatural substances, and God will protect the body from sickness; and.

Religious – This 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.

Kentucky Department for Public Health Amended Immunization Regulation. Religious exemptions shall be documented on a signed and notarized Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds to Required Immunizations.

Students must submit the original, signed, and notarized Virginia Certificate of Religious Exemption Form (Form CRE-1). The religious exemption form is located on the Commonwealth of Virginia website – search for “Religious Exemption Form Virginia”. The correct form will say Form CRE-1 at the bottom.

KRS 214.036 requires parents who object to immunization of their child to provide a written sworn statement objecting to immunization of the child on religious grounds.

In addition to medical exemptions for students with conditions that do allow them to receive vaccinations, Kentucky allows parents to exempt their children for religious reasons, but Humbaugh said that accounts for less than 2 percent of all exemptions.