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This page has links to our Letters directory. These documents were put together over a period of years.

General documents, available for modification and use in all states is here: Scroll down.
See documents specific to your state below.
Warning these documents may be outdated. In any case, if used, they should be modified to fit your beliefs and circumstances. There are over 200 documents so we don't have time to carefully inspect each.





4 NBS.pdfMay be outdated

7-1393-1.pdfMay be outdated

73Antigens.docMay be outdated

AAPmodified.docMay be outdated

AAPmodified.htmMay be outdated

AAPmodified.pdfMay be outdated

AcceptanceResponsibilityRELIGIOUS.docMay be outdated

AFFIDAVIT-for-adult-college.docMay be outdated

Affidavit-adult.docMay be outdated

Affidavit-birth.docMay be outdated

Affidavit-birth.htmMay be outdated

anairhoads.htmlMay be outdated

AttackingDNAwith-infectious-agents.docMay be outdated

B18-RE_1.pdfMay be outdated

birthplan-itemized.docMay be outdated

birthplan-itemized.pdfMay be outdated

bizland-exemption.pdfMay be outdated

Certificate-of-live-birth.htmMay be outdated

cfrm_acir_contraindication.pdfMay be outdated

ChildCareExemptForm.pdfMay be outdated

cholera_letter.gifMay be outdated

clinicguide.htmMay be outdated

decline-HepB.pdfMay be outdated

DHEC-1123.pdfMay be outdated

DHEC-1126.pdfMay be outdated

DHEC-1148.pdfMay be outdated

doctor.htmMay be outdated

Exemption for TB testing.docMay be outdated

Exemption for TB testing.pdfMay be outdated

Immunization Declination Statement 7-03.docMay be outdated

Immunization.pdfMay be outdated

IMMUNIZATION WAIVER.pdfMay be outdated

JLCB-IMMUNI~4.docMay be outdated

Lead_testing_waiverGen.docMay be outdated

Lead_testing_waiverGen.htmMay be outdated

Letter explanation to doctor.docMay be outdated

Letter-to-doctor.docMay be outdated

med_waiver_eng.pdfMay be outdated

med_waiver_spa.pdfMay be outdated

military-optout2.pdfMay be outdated

Model11425.docMay be outdated

Model11426.docMay be outdated

Model letter for hospital births 2.docMay be outdated

Model letter for hospital births for adoptions.docMay be outdated

nursesServiceForms2003.pdfMay be outdated

OSHAexemption.docMay be outdated

OSHAexemption.pdfMay be outdated

opt_out.docMay be outdated

Pet Vaccine Ltr Bangor Daily 12-31-04.emlMay be outdated

PROOF OF IMMUNIZATION COMPLIANCE LA Generic Form.docMay be outdated

refusal_treatment.pdfMay be outdated

RefuseVaccines1.docMay be outdated

RefuseVaccines1.pdfMay be outdated

Registration vs. Recording (concerning birth certificates & marriage licenses).docMay be outdated

ReligiousObjectionForGeneticMetabolicScreening.docMay be outdated

ReligiousObjectionForGeneticMetabolicScreening.pdfMay be outdated

Right-to-refuse-flu-shots1.docxMay be outdated

Right-to-refuse-flu-shots.pdfMay be outdated

TBTestingWaiverAdult.docMay be outdated

TBTestingWaiverAdult.pdfMay be outdated

TBTestingWaiverAdult.wpdMay be outdated

TB Testing Waiver.docMay be outdated

TB Test Pkg Ins - Tubersol - Aventis 09-2001.pdfMay be outdated

TBwaiverGen.docMay be outdated

TBwaiverGen.htmMay be outdated

Vaccination Waiver Form.pdfMay be outdated

VitaminK-WaiverForConsent.docMay be outdated

VitaminK-WaiverForConsent.pdfMay be outdated

VitaminK-WaiverForConsent.rtfMay be outdated

VitaminK-WaiverForConsent.wpdMay be outdated

vitk-eryth.htmlMay be outdated

waiver_eng.pdfMay be outdated

Why-did-God-create-cancer.pdfMay be outdated

Index of documents by state: Alabama  |   Alaska  |   Arizona  |   Arkansas  |   [Australia]  |   California  |   [Canada]  |   Colorado  |   Connecticut  |   Delaware  |   District of Columbia  |   Florida  |   Georgia  |   [GUAM]  |   Hawaii  |   Idaho  |   Illinois  |   Indiana  |   Iowa  |   Kansas  |   Kentucky  |   Louisiana  |   Maine  |   Maryland  |   Massachusetts  |   [Mexico]  |   Michigan  |   Minnesota  |   Mississippi  |   Missouri  |   Montana  |   Nebraska  |   Nevada  |   New Hampshire  |   New Jersey  |   New Mexico  |   New York  |   [New Zealand]  |   North Carolina  |   North Dakota  |   Ohio  |   Oklahoma  |   Oregon  |   Pennsylvania  |   [Puerto Rico]  |   Rhode Island  |   South Carolina  |   South Dakota  |   Tennessee  |   Texas  |   Tribal_Vax  |   Utah  |   Vermont  |   Virginia  |   Washington  |   West Virginia  |   Wisconsin  |   Wyoming

Alabama

Alabama exemption letter.docMay be outdated

Alabama exemption letter for a parent who can't edit this document.docMay be outdated

Alaska

Arizona

ExemptionVacLib-Arizona.docMay be outdated

ExemptionVacLib-Arizona.pdfMay be outdated

Arkansas

AFFIDAVIT for Arkansas Adult.docMay be outdated

AFFIDAVIT for Arkansas Adult.wpdMay be outdated

AFFIDAVIT for Arkansas Older Child.docMay be outdated

aK_pract_man.pdfMay be outdated

Arkansas Exemption letter (applying for state issued exemption).docMay be outdated

Arkansas Exemption letter (state issued).docMay be outdated

ARvax1.pdfMay be outdated

ARvax2.pdfMay be outdated

Mod_ARvax2.docMay be outdated

Mod_ARvax2.pdfMay be outdated

[Australia]

California

AFFIDAVIT for California Older Child.docMay be outdated

CA-AdultExemption.docMay be outdated

CAExemption.pdfMay be outdated

Calif-Adventist-letter.htmMay be outdated

Calif-olderchild.htmMay be outdated

CA-SchoolExemption.docMay be outdated

TBCalif.docMay be outdated

TBCalif.htmMay be outdated

TBCalif.pdfMay be outdated

TBCalif.wpdMay be outdated

Waiver of Health Examination For School Entry California pm171b(bi).pdfMay be outdated

Waiver of Health examinations (pg 2 in Spanish).pdfMay be outdated

waiver_spanish.pdfMay be outdated

RosamondPreschoolExemption.pdfMay be outdated

[Canada]

Colorado

Acceptance of Responsibility - COLORADO.docMay be outdated

ADPImmunWaiver.pdfMay be outdated

AFFIDAVIT_Colorado_newborn.docMay be outdated

AFFIDAVIT for Colorado Adult.docMay be outdated

AFFIDAVIT for Colorado Older Child.docMay be outdated

Colorado11507.docMay be outdated

Colorado11507.pdfMay be outdated

Colorado11508.docMay be outdated

Colorado-newborn.htmMay be outdated

Colorado-olderchild.htmMay be outdated

Connecticut

Delaware

District of Columbia

District Exempt.docMay be outdated

District Exempt.pdfMay be outdated

District Exempt.wpdMay be outdated

ExemptionVacLib-DC.docMay be outdated

Florida

Form681.pdfMay be outdated

Georgia

AFFIDAVIT for Georgia Child.docMay be outdated

Georgia_Affidavit_daycare_school.docMay be outdated

Georgia_Affidavit_daycare_school.pdfMay be outdated

Georgia-Sample.docMay be outdated

Georgia-Sample.pdfMay be outdated

GeorgiaTitle20.docMay be outdated

GeorgiaTitle20.htmlMay be outdated

Immunization GA employment.docMay be outdated

ImmunizationGeorgia11412.docMay be outdated

[GUAM]

Hawaii

AFFIDAVIT for Hawaii Older Child.docMay be outdated

ExemptionVacLib-Hawaii.docMay be outdated

ExemptionVacLib_Hawaii.pdfMay be outdated

ExemptionVacLib-Hawaii.pdfMay be outdated

ExemptionVacLib-Hawaii.wpdMay be outdated

Hawaii Admininistrative Code.pdfMay be outdated

Idaho

State_Of_Idaho_Certificate_Of_Exemption.pdfMay be outdated

NewIdahoExemptionForm.docMay be outdated

NewIdahoExemptionForm.pdfMay be outdated

Illinois

Illinois Catholic religious exemption for VARIVAX.docMay be outdated

Illinois Catholic Religious Exemption letter.docMay be outdated

Illinois Religious exemption letter.docMay be outdated

IllinoisReligiousexemptionletter.docMay be outdated

Indiana

ExemptionVacLib-Indiana.docMay be outdated

Iowa

Kansas

AcceptanceResponsibilityRELIGIOUS (Kansas).docMay be outdated

AFFIDAVIT for Kansas Older Child.docMay be outdated

Kentucky

ExemptionVacLib-Kentucky.docMay be outdated

Louisiana

AFFIDAVIT for Louisiana Newborn.docMay be outdated

Louisiana.docMay be outdated

Maine

Maryland

ExemptionVacLib-Maryland.docMay be outdated

ExemptionVacLib-Maryland.pdfMay be outdated

ExemptionVacLib-Maryland.wpdMay be outdated

Massachusetts

AFFIDAVIT-for-Massachusetts-Adult-college.docMay be outdated

AFFIDAVIT for Massachusetts Adult (college religious exemption) M.G.L. c. 76, ss 15C;.docMay be outdated

AFFIDAVIT for Massachusetts Older Child.docMay be outdated

AFFIDAVIT_Massachusetts_Adult(college_religious_exemption).docMay be outdated

[Mexico]

Michigan

Minnesota

AFFIDAVIT for Minnesota Adult.docMay be outdated

MN11403.pdfMay be outdated

MSAD #34 Immunization Exemption Form.pdfMay be outdated

MSAD 34 Immunization Exemption Form.pdfMay be outdated

Mississippi

Missouri

Montana

Nebraska

Nevada

Written Statement Claiming Religious Exemption from Vaccination NEVADA.docMay be outdated

NV_VaccExemption.pdfMay be outdated

Nevada - Pershing County School District Health Information for Parents (info-immunizations).pdfMay be outdated

Nevada Religious exemption letter.docMay be outdated

ExemptionVacLib-Nevada.docMay be outdated

New Hampshire

NH_religious.pdf

NHWebmailCertRelExemp(5189).docMay be outdated

New Jersey

AcceptanceResponsibilityRELIGIOUS for NJ.docMay be outdated

AFFIDAVIT for New Jersey Older Child.docMay be outdated

New Mexico

New York

AFFIDAVIT for New York Adult (colleges).docMay be outdated

AFFIDAVIT for New York Newborn.docMay be outdated

AFFIDAVIT for New York Older Child.docMay be outdated

NYSED-Religious-Exemption-Form.pdfMay be outdated

[New Zealand]

North Carolina

NorthCarolina11436.docMay be outdated

NorthCarolina11437.docMay be outdated

NorthCarolina11438.docMay be outdated

NC-Exemption.pdfMay be outdated

ExemptionVacLib_NorthCarolina.pdfMay be outdated

North Dakota

North Dakota Immunization Form.pdfMay be outdated

Ohio

ACCEPTANCE OF RESPONSIBILITY-Ohio.docMay be outdated

AFFIDAVIT for Ohio Older Child.docMay be outdated

State Of Ohio Legal Immunization Exemption.pdfMay be outdated

Ohio-Exemption-Form.docMay be outdated

Ohio-Exemption-Form.pdfMay be outdated

Oklahoma

Oklahoma-exemption-form.pdfMay be outdated

Oregon

AFFIDAVIT for Oregon Newborn-New.docMay be outdated

AFFIDAVIT for Oregon Newborn-New.wpdMay be outdated

Affidavit-Oregon-newborn.htmlMay be outdated

Immunizations OR child (5186).docMay be outdated

Immunizations OR Employment (5185).docMay be outdated

Oregon-p32-refusal-form.jpg

Letter_Oregon_School_District.htmMay be outdated

Pennsylvania

PA-SAMPLE-EXEMPTION-LETTER.docxMay be outdated

Pennsylvania10986.docMay be outdated

PennsylvaniaHebB10985.docMay be outdated

PennsylvaniaStatement10987.docMay be outdated

[Puerto Rico]

Rhode Island

Rhode Island Religious Vaccine Exemption Form.pdfMay be outdated

South Carolina

SouthCarolina5183.docMay be outdated

South Dakota

ExemptionVacLib-SD.docMay be outdated

ExemptionVacLibSD.pdfMay be outdated

Vaccination Exemption Pursuant to South Dakota Codified Law.do

Tennessee

Tennessee religious exemption letter.docMay be outdated

Texas

ACCEPTANCE OF RESPONSIBILITY-TEXAS.docMay be outdated

AFFIDAVIT forTexas Newborn.docMay be outdated

RequestTexas6323.docMay be outdated

Texas

Tribal_Vax

Utah

Vermont

ExemptionVacLib-Vermont.docMay be outdated

ExemptionVacLib_Vermont.pdfMay be outdated

ExemptionVacLib-Vermont.pdfMay be outdated

Virginia

Washington

AFFIDAVITforWashingtonAdult.docMay be outdated

AFFIDAVIT for Washington newborn.docMay be outdated

City of Spokane - Appendix FC2B - HepB Declination.docMay be outdated

City of Spokane - Appendix FC2B - HepB Declination.pdfMay be outdated

ExemptionVacLib-Washington (11439).docMay be outdated

ExemptionVacLib-Washington.docMay be outdated

WashingtonReligiousexemption.docMay be outdated

UW Stout 1305.pdfMay be outdated

West Virginia

Wisconsin

AFFIDAVIT-TB-Wisconsin.docMay be outdated

AFFIDAVIT-TB-Wisconsin.rtfMay be outdated

ExemptionVacLibWisconsin.docMay be outdated

ExemptionVacLibWisconsin.pdfMay be outdated

Wyoming





Vaccination Liberation - Idaho Chapter
"Free Your Mind....From The Vaccine Paradigm"
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