This form is a sample letter in Word format covering the subject matter of the title of the form.
Sample Religious Exemption Letter For School In Middlesex
Category:
State:
Multi-State
County:
Middlesex
Control #:
US-0012LR
Format:
Word;
Rich Text
Instant download
Description
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FAQ
The Pennsylvania Code § 23.84. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.
There is no form for requesting religious exemptions in North Carolina. To claim a religious exemption, the parent or person requesting the exemption must write a statement of their religious objection to immunization, including the name and date of birth of the person for whom the exemption is being requested.
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:
Download and complete the Ontario Ministry of Health's Statement of Medical Exemption (Immunization of School Pupils Act). If you're unable to access the form, contact the vaccine team to have one emailed or mailed to you. Have a physician or nurse practitioner complete the form. Keep a copy for your personal records.
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.)
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.
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.
How to fill out the Pennsylvania Immunization Exemption Letter? Enter your name and address in the specified fields. Provide the date at the top of the letter. Clearly articulate your objection to immunization. Sign the letter as a parent or legal guardian. Submit the letter as required by Pennsylvania law.
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.
