(see my red bold below) Now keep in mind that "given the opportunity to read" doesn't mean the parent must read them. They just need to <i>acknoweldge</i> they were given the opportunity to read them -- they are not required to sit there and read it or have it read to them. The form also asks the parent to acknowledge they have had the opportunity to speak with their doctor, but that doesn't mean they have to do this, nor do they have to prove they spoke with their doctor.<br><br>
I would tell your friend to make a formal complaint: Commissioner Susan R. Cooper, MSN, RN (Tel 615-741-3111)<br><br><br><i>Tennessee Department of Health<br>
Communicable and Environmental Disease Section<br>
Vaccination(s) Refusal Due To Personal Religious Beliefs<br><br>
Child's Name______________________________Parent/Guardian_________________<br>
Address___________________________________________ ____State______Zip___________<br><br>
Phone(____)_______________<br><br><br>
I have been advised my child or ward (named above) should receive the following vaccines but I am declining to have my child immunized.<br><br>
Declined(Check all that apply)<br><br><br>
__Hepatitis B Vaccine<br>
__Measles, Mumps, Rubella Vaccine(MMR)<br>
__Diphtheria, Tetanus, acellular Pertussis Vaccine(DTaP)<br>
__Varicella(chickenpox) Vaccine<br>
__Diphtheria, Tetanus Vaccine (DT or Td)<br>
__Influenza (flu)Vaccine<br>
__Haemophilus Influenzae type B Vaccine (Hib)<br>
__Meningococcal Vaccine<br>
__Pneumococcal conjugate Vaccine<br>
__Hepatitis A Vaccine<br>
__Polio Vaccine (IPV)<br>
__Other__________________________<br><br><span style="color:#FF0000;"><b>I have been given the opportunity to read the Centers for Disease Control and Prevention's (CDC) Vaccine information Sheet(s) (VIS) explaining the above vaccine(s) and the disease(s) they may prevent.</b></span> I have had the opportunity to discuss these with my child's health care provider or the health department and to have my questions, if any, answered. By signing below, I acknowledge and I understand the following:<br><br>
The purpose and the need for the recommended vaccine(s)<br>
The risks and benefits of the recommended vaccine(s)<br>
If my child does not receive the vaccine(s), I accept the consequences of my decision, which may include:<br>
My child contracting the illness the vaccine should prevent.<br>
My child transmitting the disease to others.<br>
The need for my child to stay out of daycare or school during disease outbreaks.<br>
I have decided to decline (indicated above) the vaccination(s) recommended for my child (indicated above) because the vaccination(s) conflict with my personal religious beliefs. Further, I affirm the truth of this statement under the penalty of perjury.<br><br>
I acknowledge I have read this document in its entirety and fully understand it.<br><br><br>
______________________________________<br>
Parent or Gaurdian Date<br><br><br>
_______________________________________<br>
Witness Date<br>
Notary Public____________________________<br>
Date Commission Expires__________________</i>