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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

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

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
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.)
Since January 1, 2016: Parents or guardians of students in any school or child-care facility, whether public or private, are no longer allowed to submit a personal beliefs exemption to a currently-required vaccine.
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.
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.
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 ...
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:
Religious exemptions are a broad category of laws that create carveouts or exceptions to existing laws, such as nondiscrimination laws. In doing so, they create a license to discriminate.