Get Statement Of Exemption To Immunization Law Commonwealth Of

Filling out the Statement of Exemption to Immunization Law provides an essential way for individuals to formally state their exemption preferences. This guide will walk you through the process of completing the form online, ensuring a clear understanding of each section.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in an online editor.
2. Fill in the personal details of the child, including their name, date of birth, address, and phone number. Ensure all information is accurate and up to date.
3. Indicate the grade of the child. This information helps in processing the exemption request accordingly.
4. For the medical exemption, select the option indicating that immunizations would endanger the child's life or health. Provide additional comments if necessary and ensure a physician's signature is obtained, along with the date signed.
5. For the religious exemption, indicate that the parent or guardian adheres to a religious belief or has a strong moral or ethical conviction against immunizations. Include any comments or explanations that further detail the beliefs.
6. Ensure the parent or guardian’s signature is included on the form along with the date signed, marking the formal submission of the exemption request.
7. Review all fields for accuracy and completeness. Once you are satisfied, you can save the changes, download a copy of the completed form, or print it for submission.

Complete your document online to ensure your exemption request is submitted correctly.