Wording for a philosophical exemption

[littlec]

I need to turn in an exemption form to my kids' school, and here's what I found online:

Under State Revised Statutes 17:170, I hereby claim exemption from the immunization requirement for Philosophical/Personal reasons.
 

(Statement of dissent for philosophical/personal reasons.) 
 

I understand that in the event of an outbreak of a vaccine-preventable disease at the location of the educational institution or facility the student attends, the administrators of the educational institution or facility, upon the recommendation of the office of public health, may exclude the student from attendance until the incubation period has expired or I present evidence of immunization.
_____________________________ Student signature
_____________________________ Date
_____________________________ Parent or Guardian's signature (if required)

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  Do I need to write a "statement of dissent"? Anyone have any suggestions as to what to write? Should I explain my child's possible vax reaction? I'm also going to enclose a hard copy of the state status.

Thanks!!

[ma2two]

Are you in Louisiana?

Louisiana Administrative Code, section 1121 (Louisiana Handbook for School Administrators)

"No student seeking to enter any school shall be required to comply with the provisions of this Section if the student or his parent or guardian submits either a written statement from a physician stating that the procedure is contraindicated for medical reasons, or a written dissent from the student or his parent or guardian is presented."

doa.louisiana.gov/osr/lac/28v115/28v115.doc

page 32 (cut and paste the above link into your browser)

I would delete the whole section about exclusion during an outbreak. I would write a very simple statement that I object to the immunization requirements.

Edited by ma2two - 9/15/11 at 10:03pm