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  • Immunization Record/statement Of Exemption - Connections Academy

Get Immunization Record/statement Of Exemption - Connections Academy

Student Name: Date of Birth: / / Refer to the Document Cover Page for instructions on submitting this form. Immunization Record/Statement of Exemption Immunization information is required for all.

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How to fill out the Immunization Record/Statement of Exemption - Connections Academy online

This guide provides clear, step-by-step instructions to assist users in filling out the Immunization Record/Statement of Exemption for Connections Academy. Completing this form accurately is essential for students entering public school.

Follow the steps to complete the form online.

  1. Click ‘Get Form’ button to access the Immunization Record/Statement of Exemption and open it in the designated online editor.
  2. Enter the student’s name and date of birth in the specified fields. Ensure that the information is accurate.
  3. Fill in the street address, city, state, and ZIP code of the student’s residence.
  4. For the immunization section, this must be completed by a healthcare provider. Ensure that they fill in the required vaccines and corresponding doses administered.
  5. If applicable, select the appropriate exemption statement based on physical condition or personal beliefs. Complete the related fields as required.
  6. Review all entered information for accuracy. Make any necessary corrections.

Complete your immunization documents online today for a smooth enrollment process.

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Related links form

Federal MIF Local Government Supplemental Information Us GUEST LICENSURE BY TEMPORARY PERMIT APPLICATION INFORMATION This Document May Be Made Available Minnesota Immunization Information Connection (MIIC) APPLICATION FOR CERTIFICATE OF AUTHORITY ... - Minnesota.gov - Mn

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No. Indiana law only allows religious objection or medical exemption.

How can I submit a medical or religious exemption form? Someone requesting an immunization exemption due to medical conditions or religious beliefs must: 1. Submit a written statement on a form provided by the Division of Public and Behavioral Health of the Department of Health and Human Services.

VACCINE EXEMPTION FORM religious beliefs. IC § 20-34-3-2.

(a) Except as otherwise provided, a student may not be required to undergo any testing, examination, immunization, or treatment required under this chapter or IC 20-34-4 when the child's parent objects on religious grounds.

2 doses are required for all grades Pre-K through 12. COVID-19: COVID-19 vaccine is recommended for all students five years of age and older per CDC and FDA's Emergency Use Authorization.

Indiana 2021-2022 Required and Recommended School Immunizations printable list GradeRequired Pre-K 3 Hepatitis B 4 DTaP (Diphtheria,Tetanus & Pertussis) 3 Polio K-5th grade 3 Hepatitis B 5 DTaP 4 Polio 6th-11th grade 3 Hepatitis B 5 DTaP 4 Polio 2 Varicella 12th grade 3 Hepatitis B 5 DTaP 4 Polio 2 Varicella

Code § 21-40-5-6. Section 21-40-5-6 - Religious objections (a) Except as otherwise provided, a student may not be required to undergo testing, examination, immunization, or treatment required under this chapter when the student objects on religious grounds.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232