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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

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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 ...
I request to be exempted from the vaccine requirement on the basis of my bona fide religious belief, observance or practice. The following information is submitted in support of my request. (Please attach additional pages if needed.)
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.
Student Statement: In the space below, please describe the following: (1) your sincerely held religious belief or practice that is the basis for your request for a religious accommodation; and, (2) how your sincerely held religious belief or practice conflicts with the New York State Vaccination Requirements.
Four states currently do not allow religious exemptions from these vaccination requirements: California, Mississippi, New York, and West Virginia. Maine is currently set to become the fifth such state when its law eliminating the exemption takes effect in September 2021.
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.
If you qualify for an exemption, you can report it when you file your New Jersey Income Tax return (Resident Form NJ-1040) using Schedule NJ-HCC. Individuals who are not required to file a New Jersey Income Tax return are automatically exempt and do not need to file just to report coverage or claim the exemption.
Religious exemptions extend to private, parochial, and public institutions. When a parent or guardian submits a written, signed request for exemption from mandatory immunization(s) due to religious beliefs, the statement should be accepted and the religious exemption granted.