Thoughts on this exemption letter? Should I add or change anything
Immunization Exemption Letter
05/02/2008
To Whom It May Concern:
Re: Religious Exemption
We____________________________, as the parents of the child_________________ after considering the risks and benefits of the vaccine(s) and our religious grounds we do hereby decide not to vaccinate our child with any and all vaccines.
rotavirus
Diphtheria
Pertussis
Tetanus
Measles
Mumps
Rubella
Polio
Varicella
Hepatitis B
Hepatitis A
Prevnar
Anthrax
Smallpox
Haemophilus influenzae type b
influenza
ยง 23.84. Exemption from immunization. [28 PA. CODE CH.23]
(b) Religious exemption. 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.
Date: ____________________
__________________________________
Parent/Guardian
__________________________________
Parent/Guardian
Immunization Exemption Letter
05/02/2008
To Whom It May Concern:
Re: Religious Exemption
We____________________________, as the parents of the child_________________ after considering the risks and benefits of the vaccine(s) and our religious grounds we do hereby decide not to vaccinate our child with any and all vaccines.
rotavirus
Diphtheria
Pertussis
Tetanus
Measles
Mumps
Rubella
Polio
Varicella
Hepatitis B
Hepatitis A
Prevnar
Anthrax
Smallpox
Haemophilus influenzae type b
influenza
ยง 23.84. Exemption from immunization. [28 PA. CODE CH.23]
(b) Religious exemption. 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.
Date: ____________________
__________________________________
Parent/Guardian
__________________________________
Parent/Guardian






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