Your law does not mention public or private, it simply states that
licensed daycares are not required to have documentation of immunization from those with exemptions.
If your state doesn't have an official form I have a letter; just add your law.
If your state does have a form, I would staple the law from the state website.
TITLE 22. SOCIAL SERVICES
AGENCY NO. 15. CHILD DAY-CARE COUNCIL
CHAPTER 30. STANDARDS FOR LICENSED CHILD DAY CENTERS
PART II. ADMINISTRATION22 VAC 15-30-150 (2007)22 VAC 15-30-150 Immunizations for children.
A. The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center.
Exemptions (subsection C of § 22.1-271.2 of the Code of Virginia and 12 VAC 5-110-110 of the Regulations for the Immunizations of School Children): Documentation of immunizations is not required for any child whose
(i) parent submits an affidavit to the center, on the form entitled "Certification of Religious Exemption," stating that the administration of immunizing agents conflicts with the parent's or child's religious tenets or practices, or
(ii) physician or a local health department states on a MCH 213B or MCH 213C, or other Department of Health-approved formthat one or more of the required immunizations may be detrimental to the child's health.
B. The center shall obtain documentation of additional immunizations once every six months for children under the age of two years.
C. The center shall obtain documentation of additional immunizations once between each child's fourth and sixth birthdays.
Sample Religious Exemption Letter(change the state law reference):
Quote:
To whom it may concern;
(We / I) {First and Last name(s)}, as the {(parent (s) / guardian(s)} of ______________________(name of newborn child) are exercising (our/my) rights under the US Constitution, PUBLIC HEALTH LAW, ARTICLE 21. CONTROL OF ACUTE COMMUNICABLE DISEASES,TITLE VI. POLIOMYELITIS AND OTHER DISEASES, NY CLS Pub Health § 2164 (2002), to receive Religious Exemption from Vaccination, ALL injections, prophylaxis, & testing due to our genuine and sincere religious beliefs which are contrary to the practices herein required.
The U.S. Supreme Court held in Frazee V. Illinois Dept. of Security, 489 U.S. 829, that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. This ruling is also reflected in Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.
Sincerely,
Your signature.
Date
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