KANSAS - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)

IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)

Note: Be advised that websites and links change constantly. It would be wise to go through this page and save ALL the exemption forms and letters, in case a website goes down. Please share with others who also want to refrain from medical experimentation.

Kansas

Current Statutes & Laws:
http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/kansas.aspx
Medical & Religious

"Submit a written statement signed by a parent that the parent is an adherent of a religious denomination whose teachings are opposed to immunizations"
Note: That can be challanged. It is unconstitutional, as it restricts religious exemptions from vaccination solely and exclusively to "bona fide members of a recognized religious organization".
Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group e spouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.
For additional help with exemptions, birth plan,etc questions:
Non_Vaccinating_Physicians

Check our Vaccination Liberation State Chapter and other resource organizations page for help in your state.

If your state specific help is not available, Contact us.


PDF documents (.pdf)

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Exemption Letters & Forms...

Birth Exemptions:

For those who are planning a hospital birth but want to evade invasive routine post natal procedures such as a Hep B shot, vitamin K injection, newborn screening, or the application of silver nitrate in the newborn's eyes, a very specific birthing plan must be submitted to the hospital in advance of the birth. Hospital staff must be informed, in advance, of your needs, wants and desires where your baby and birthing experience are concerned. The same applies to midwives.

The Kansas Department of Health and Environment
Newborn Screening Program
http://www.kdheks.gov/newborn_screening/

Newborn Screening Practitioner's Manual...(Out of date, Archived on archive.org)
http://web.archive.org/web/20120228175129/http://www.kdheks.gov/newborn_screening/practitioner_manual.htm

(.pdf) [ARCHIVED] Appendix_C_Religious_Objection_Example.pdf (Sample Only)
*However, we were able to make exact copies without sample only stamp.
Note: this form is no longer offered on Kansas State website. Below are Appendix C Religious Objection letters to download and use:
(.doc) ../letters/ReligiousObjectionForGeneticMetabolicScreening.doc

(.pdf) ../letters/ReligiousObjectionForGeneticMetabolicScreening.pdf

May I refuse these tests?
Most states have specific laws regarding newborn screening. In Kansas you may refuse for religious reasons. If you do so, you may be asked to sign a refusal form. This form relieves your doctor of liability for damages that result from a disorder that could have been detected by screening.
Example refusal form:

28-4-512. Parental education.
(a) Providers of prenatal health care shall discuss and distribute written material describing the newborn screening program as a component of the prenatal care to pregnant women.

(b) Prior to obtaining the specimen for newborn screening, the person responsible for obtaining the specimen shall inform the parent or parents about the newborn screening program, including how the test can be refused. Authorized by K.S.A. 65-101; implementing K.S.A. 65-182; effective, T-87-48, Dec. 19, 1986; effective May 1, 1987.

See letters above for sample refusal form

Newborn Screening Regulations in Kansas: [Kansas Administrative Regulations]
Pages 29-32
[PDF] (28-4-501 through 28-4-513)

Hearing Screening...

KANSAS

Statute: Sec.1 (c) Informed consent of parents shall be obtained and if any parent or guardian of a child objects to the mandatory examination for detection of significant hearing loss the child is exempt from subsection (b) of this section.

[Source: House Bill No. 2362]

Vitamin K Injection...

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
(.pdf) http://vaclib.org/chapter/inserts.htm#vitK
"WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."
fatalities=death
Merck Vitamin K Package Insert - Aquamephyton PI | Scribd

The package insert should be printed out and used along with the birth plan letter, and your exemption letter or AFFIDAVIT. This shows the hospital or birthing center that you are aware of the risks of Vitamin K injection, and that they should be too.

Alternatives to Vitamin K Prophylaxis...

Although oral vitamin K is not licensed for use as a drug by the FDA, drops for oral administration are available. Typically, one drop contains 2 mg. of vitamin K. Contact a midwife in your area, or a birthing supply company (such as birthwithlove.com), or Scientific Botanicals (206 527-5521) where your health care provider can order liquid vitamin K directly.

Here's another safe alternative that your chiropractor or naturopath can order for you. Or order directly from Amazon.com

Biotics Research, Bio-K Mulsion - 1 fl oz

A good organic whole food diet along with lots of leafy green vegetables is all that is necessary to prevent vitamin K deficiency in newborns.

Sample Vaccine Letters

Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in the following manner. (Usually, you'll never find anybody in the hospital to sign this simple form):

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.
(Links to model birth plan letter and acceptance of responsibility)
Acceptance of Responsibility. http://www.vaclib.org/legal/accept1.htm

Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage:
(.pdf) http://drtenpenny.com/wp-content/uploads/2012/06/Hep_B_in_the_hospital_1_.pdf
This form is generic. It can be used in other states.

(Links to model birth plan letter and acceptance of responsibility)
Acceptance of Responsibility. http://www.vaclib.org/legal/accept1.htm

Model Birth Plan Letter for Hospital Births. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc...

(.doc) Model Letter for Hospital Births (Model11425.doc)

Model Birth Plan Letter for Hospital Births. This one is more detailed. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc...

(.doc) Model letter for hospital births 2.doc (11426)

Model Birth Plan Letter for Hospital Births for an adopted child...
Model letter for hospital births for adoptions -- Dear Doctor and Medical Staff.doc (11427)

(.doc) VaccineTruth.net/letters/Model letter for hospital births for adoptions.doc

The above documents can also be made available in WordPerfect (.wpd) format.
Please Contact us if you want the model birth plan letters in WordPerfect.

Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage:
(.pdf) http://www.drtenpenny.com/wp-content/uploads/2012/06/Hep_B_in_the_hospital_1_.pdf
This form is generic. It can be used in other states.

Sample Birth Plan from The Center of Unhindered Living

The birth plan arrangements and letter should be turned in before delievery date.

This "Refusal to Permit Medical Treatment" form is optional to use.

"Refusal to Permit Medical Treatment" form
Refusal to Permit Medical Treatment. A generic form.
(.pdf) ../letters/refusal_treatment.pdf

It would be ideal to use with the AFFIDAVIT below AND model birth plan letter. We hope prospective parents use these affidavits, model birth plan letters, refusal forms, and succeeds. We would LOVE to hear your success stories. The ACCEPTANCE OF RESPONSIBILITY is imperative in exercising your rights for legal exemptions from forced medical experimentation and legalized bioterrorism. BE prepared to fight for your baby's rights!

Birth plan religious AFFIDAVIT text below. Use with model birth plan letter and/or refusal forms, and edit as needed...
Copy and paste into Word Processing software, and edit as needed.


This is a sample. Modify to reflect your own beliefs.
AFFIDAVIT

I/We, _________________________, state Citizen(s) of the Kansas Republic affirm: Be it known to all courts, governments, and other parties that:

Being (a person/people) of Strong Christian Morals, it is against (my/our) Deep, Sincerely Held, Religious Convictions to accept the injection of any foreign substance into (my Body/our Bodies) or the Body of (my/our) Child. This includes, but is not limited to, any and all, Vaccinations, Shots, Tests for Diseases, Oral Vaccines, Epidermal Patches and in any other way that Live or Killed Bacterium, Viruses, Pathogens, Germs, or any other Microorganisms, may be introduced into or upon (my/our) newborn's body.

This written statement to exempt (my/our) newborn from any immunizations, newborn screening, and the Vitamin K shot, because (I/we) hold genuine and sincere personal religious beliefs which are inconsistent with these medical procedures & experimentation. The practice of vaccination and the injection or application of any foreign substance is contrary to (my/our) conscientiously held religious beliefs and practices, and violates the free exercise of (my/our) religious principles.

The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps (my/our) parental authority to condemn such activity in (my/our) child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of (my/our) faith.

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
http://vaclib.org/chapter/inserts.htm#vitK
"WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."
A conflict arises because (my/our) religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of injection of carcinogenic substances that can kill.

(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 First Amendment of the US Constitution and KR.S. 16-41-17-2(c), Statute: Sec. 2. (c) to receive Religious Exemption from Vaccination, ALL injections, & testing.

Applicable law has been interpreted to mean 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. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.

The Lord Jesus Christ and Our Creator are the only source of protection of (my body/our bodies) and that of (my/our) family that (I/we) can accept.

(I/We) affirm that vaccination & injections of any foreign substances and proteins conflict with (my/our) religious beliefs as stated above. Therefore, (I/we) would request that you accommodate (my/our) religious beliefs and practices by exempting (my/our) newborn child from any vaccinations, injections and testing of any kind.

Rest assured that (my family and I/our family) do practice a form of immunization that keeps our immune systems strong and is in keeping with Biblical principles.


The use of notary below is for identification only, and such use does NOT grant any jurisdiction to anyone.

Subscribed and sworn, without prejudice, and with all rights reserved, (Print Name Below)


_______________________________________________________________,



_______________________________
Signature of Affiant

       ACKNOWLEDGMENT

state of Kansas

county of _________________:

On this _______ day of ______________, 201__, before me

personally appeared __________________________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged that he executed the same as his free act and deed, for the purposes therein set forth.


        _______________________________________
        (Notary Public)

My Commission Expires ______________________________, 200___



Hearing Screening

Statute: Sec.1 (c)
Informed consent of parents shall be obtained and if any parent or guardian of a child objects to the mandatory examination for detection of significant hearing loss the child is exempt from subsection (b) of this section.

[Source: House Bill No. 2362]
In accordance with Kansas Statute: Sec.1 (c) (I/we) certify that the hearing screening to my child, ________________________, is contrary (our/my) personal religious beliefs, held either individually or jointly with others, and (I/we) therefore request that my child be exempt from the hearing screening and examinations of Kansas Statute: Sec. 1 (b).


Signature: __________________________________ Date: ________________________

Signature: __________________________________ Date: ________________________



Birth Certificate and Marriage License Opt-Out:

Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so?
See: Marriage Licenses, Birth Certificates & #SSNs

Postnatal - 2 months (first "well baby" visit):

If you do take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware and careful of any forms you sign.

We're referring to those "Refusal To Vaccinate" forms put out by the American Academy of Pediatrics. Go to this page below and find out why signing this form is very dangerous. We all know about these forms and how they can be used to undermine parental rights...
http://www.vaclib.org/legal/donotsign.htm

"By endorsing this particular waiver, parents would essentially be signing an admittance of neglect and or "abuse" for refusing vaccines. The language contained in this waiver could put parents and caregivers in jeopardy down-the-line if they should ever find themselves in the courts due to their child's health problems, when confronted with child protective services, divorce, or just about any matter pertaining to that child that could be used against the parent(s).

Please read any waiver provided by your child's doctor carefully before signing. Instead, offer a formally written and signed letter that simply says that you do not wish to vaccinate your child. If you are unsure of the language in the waiver, buy some time by telling your doctor that you need to consult with a lawyer before signing it. "


Anai Rhoads Ford
Human Rights Journalist
Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse by Anai Rhoads Ford, released 15 November 2005.
http://www.anairhoads.org/

Media Contact (703) 491-1903


Vaccine Refusal & Exemption Forms
http://drtenpenny.com/forms/

State Form Required: No. A religious objection may be made in writing, signed & delivered to teacher or individual who ordered immunizations. The KCI forms may also be used.   Daycare and Preschools have their own approved state form below.

Daycare & Preschools:

Day Care Forms [Combined medical and religious]
http://prairiemoon.org/wp-content/uploads/2009/09/2009-Exemption-from-Immunization.pdf

Kansas requirements, religious exemption allowed:
Immunization information and KCI forms are available at schools, at most health care providers and at the Wichita-Sedgwick County Department of Community Health, 1900 E. 9th, Wichita, KS 67214, or call 268-8441.

Kansas Certificate of Immunization (KCI Form)
(.pdf) http://www.kdheks.gov/immunize/download/KCI_Form.pdf

Kansas Certificate of Immunization (KCI Form) Form B Medical Exemption
(.pdf) http://www.kdheks.gov/immunize/imm_manual_pdf/KCI_formB.pdf

Schools:


Subj: Exemption from Immunization Form
Date: 9/10/2004 7:14:17 AM Pacific Daylight Time
From: MSiemsen@kdhe.state.ks.us
To: Services4Health@...
CC: SWatson@Kdhe.state.ks.us
Sent from the Internet (Details)

Your request for information regarding a school exemption from immunization form was referred to me.

Kansas law KSA 72-5209 (b) says as an alternative to the certification required (tests and/or inoculations) (1) An annual written statement signed by a licensed physician stating the physical condition of the child to be such that the test or inoculations would seriously endanger the life or health of the child, or (2) A written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.

At this time, Kansas state law provides for only medical or religious exemptions.

There is a medical exemption state form B that must be signed yearly by a physician, either an MD or DO. The religious exemption may be signed by the parent/legal guardian on the Kansas Certificate of Immunization (KCI)

You may download a KCI at the following address:
(.pdf) http://www.kdheks.gov/immunize/download/KCI_Form.pdf

The Medical Exemption Form B can be found at:
(.pdf) http://www.kdhe.state.ks.us/immunize/download/kci_form_b.pdf

If I can be of further assistance, please do not hesitate to contact me.



Great things are possible when people persevere

Martha Siemsen, RN, ARNP
Kansas Immunization Program Assistant Director
1000 SW Jackson, Suite 210
Topeka, KS 66612-1274
Phone 785-296-2774
Fax 785-296-6510
e-mail msiemsen@kdhe.state.ks.us
www.kdhe.state.ks.us/immunize



Did not find your state exemption form on our site?
Then try this link to forms for all 50 states and D. of Columbia.
http://experimentalvaccines.org/vaccine-exemption-forms/

Kansas Certificate of Immunization (KCI Form) Form B Medical Exemption
KCI-Form B http://www.kdheks.gov/immunize/imm_manual_pdf/KCI_formB.pdf (.pdf)

Note:   Regarding Kansas law KSA 72-5209 (b) (2)
(2) A written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.

This can be challenged. It is unconstitutional, as it restricts religious exemptions from vaccination solely and exclusively to "bona fide members of a recognized religious organization".

See:

Applicable law has been interpreted to mean 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. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.

On the U.S. Supreme Court level in Frazee v. Illinois Dept. of Security, 489 U.S. 829, 1989, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization. In addition, the Supreme Court has noted that nontraditional beliefs, including secular humanism, atheism, and nontheistic faiths, are all "religion" for the purpose of free exercise analysis. The Supreme Court in Fowler v. Rhode Island, 345 U.S. 67 (1953) held that it was "no business of the courts to say what is a religious practice or activity for one group is not religion under the protection of the First Amendment."

This requirement was also challenged in New York and the laws were amended:

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. States can only go against this if they can prove a compelling state interest is at stake. But recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon "personal" religious beliefs. [Sherr and Levy vs. Northport East-Northport Union Free School District, 672 F. Supp. 81, (E.D.N.Y., 1987); Allanson vs. Clinton Central School District, U.S.. District Court, Northern District Court, Northern District of New York (84 CV 174), 1984; Campain vs. Marlboro Central School District, Supreme Court Ulster County Special Term, November 15, 1985; Brown vs. City School District, 429 NYS2d 355; Maier vs. Besser, 73 Misc.2d 241].

New York, Public Health Law, Section 2164/5(9) had to be amended in 1989 to comply with Judge Leonard Wexler’s 1987 ruling in U.S. District Court (Levy v. Northport-East Northport Union Free School District, et.al. CV87-3116/CV87-3197). The ruling had declared the prior clause in the Public Health Code to be unconstitutional, as it restricted religious exemptions from vaccination solely and exclusively to "bona fide members of a recognized religious organization". The law was extended to college students in 1991.
(.doc) http://nyvic.org/nyvic/law/wexler/wexler.doc
Fact: Courts have repeatedly held that children can be exempted because of sincerely held personal (ie. non-organized) religious beliefs and that it is unconstitutional for State Legislatures and Health Departments to limit religious exemption to organized religions ((1) Sherr and Levy -v.- Northport-East Northport Union Free School District, 672 F. Supp. 81, (E.D.N.Y. 1987); (2) Allanson -v.- Clinton Central School District, No. CV 84-174, 5, (N.D.N.Y. May 10, 1984). (3) Mason -v.- General Brown Central School district, 86-CV-209 (N.D.N.Y)).


Vision Screening:
PARENT/GUARDIAN CONSENT/REFUSAL FOR SCREENING

A parent or guardian has the right to refuse screening on children under his/her legal custody. A written, signed statement from the parent/guardian indicating refusal is recommended for school screenings.

The Vision Screening Task Force recommends that school districts inform parents of the vision screening process prior to its occurrence in the school. This information can be provided through the school newsletter, local newspaper or other media, and/or a letter to each student’s family. Providing information about an upcoming school-screening program prior to its occurrence gives parents the opportunity to decide whether or not to allow the test to be performed on their children. A form denying permission for vision screening should be included with the letter of explanation of the procedure. If the form is not returned with the parent’s or guardian’s signature to the school by a designated time, stating the child should not be screened, the child will automatically be screened.

Written, signed parental consent is required for Infant-Toddler Part C screenings. [K.A.R. 28-4-551 (e)]

In the case of provision of EPSDT and well child clinics, vision screening is a portion of the required screening services; thus, the waiver of screening does not apply.
See Page 8 of the Vision Guidelines.
A parent or guardian has the right to refuse screening on children under his/her legal custody. A written, signed statement from the parent/guardian indicating refusal is recommended for school screenings.
(.pdf) www.kdheks.gov/bfh/download/VisionGuidelines2004.pdf

OptOutRegistry for Vaccines
and various other Opt-Outs
Vaccine Registry Opt-Outs:

KNOW YOUR RIGHTS
Confidentiality of Your Child's Vaccination Records
FERPA: The Family Educational Rights and Privacy Act
http://www.vaxchoicevt.com

     - - - - Other Opt-Outs - - - -:

Birth Certificate and Marriage License Opt-Out:

Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so?
See: Marriage Licenses, Birth Certificates & #SSNs

Military Recruiters:

STUDENT OPT OUT FORM regarding the
RELEASE OF NAME, ADDRESS, AND TELEPHONE NUMBER TO MILITARY RECRUITERS
(.pdf) Archived letter from www.militaryfreeschools.org

UNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM
Word-Document (.doc) Archived on VacLib.org: http://veterans4peace.org/opt_out.doc

SAMPLE ENGLISH - BILINGUAL FORMS FOR OPTING OUT
Act to Protect Your Privacy from Military Recruiters
Information links and forms at AFSC site

STUDENT OPT-OUT - Google Search

STUDENT OPT-OUT NOTICE regarding the instruction of sexuality to children:
STUDENT OPT-OUT NOTICE Valid in all 50 states
PDF-file (.pdf) http://www.armenianchurchlibrary.com/files/national_opt-out.pdf

STUDENT OPT-OUT NOTICE - Google Search



Colleges:

HASKELL INDIAN NATIONS UNIVERSITY
CERTIFICATE OF IMMUNIZATION (12/04)
STATEMENT OF EXEMPTION TO IMMUNZATION at bottom of page...
http://www.haskell.edu/downloads/admission/HINU%20Immunization%20Form.pdf

THE UNIVERSITY OF KANSAS
MMR and WAIVER OF MENINGOCOCCAL MENINGITIS IMMUNIZATION bottom of page 2
(.pdf) http://www.studenthealth.ku.edu/sites/studenthealth.drupal.ku.edu/files/docs/ImmandHHF.pdf

Baker University
1500 Sw 10Th
Topeka, Kansas 66604-1353
Exemption is on page 2
(.pdf) http://www.bakeru.edu/images/pdf/BL_undergrad/healthform.pdf
Religious/Philosophical Exemption to Immunization Requirement
I ____________________________________________or

______________________________________________ object to the immunization of (circle) myself/the above named student to measles, rubella, mumps, diptheria/tetanus, polio. It is understood that exposure to these communicable diseases may cause disabilities and complications; and that in the event of a measles or rubella outbreak on campus, the above named student will be excluded from campus.
_____________________________________________
Signature of Student                         Date
(Parent/Guardian if student is under 18)
Kansas Wesleyan University
Salina, Kansas 67401-6196
(.pdf) http://www.kwu.edu/sites/default/files/Emergency%20Medical%20Form_1.pdf
Exemption on page 2.

Kansas State University
HEPATITIS B IMMUNIZATION DECLINATION FORM
(.pdf) http://www.humec.ksu.edu/documents/hn/hepB_immun.pdf

Manhattan Christian College • Student Development Office • 2006-2007
Meningitis Record/Waiver
(.pdf) http://www.mccks.edu/sites/default/files/Meningitis%20Record%3AWaiver.pdf

http://www.mccks.edu/meningitis-recordwaiver (web page for registering a waiver)

Pittsburg State University
1701 S Broadway
Pittsburg, Kansas 66762
For Housing Students. Only Meningitis Waiver is needed to be filled out. Provided by Health Center of school.
Immunizations/TB Testing
Pittsburg State University does not require students to show proof of immunizations against certain communicable diseases. However, as a preventative measure, the American College Health Association (ACHA) has recommended that colleges offer students and parents an immunization guideline for your consideration.
http://www.pittstate.edu/office/health/immunizations-allergy-injections.dot

Friends University
2100 W. University St.
Wichita, Kansas 67213
Click here for Immunization Policy


These Google searches are mostly the college and school exemptions. There are always new forms coming online. Keep a regular check on these to look for newly added forms. Some are for daycare too. The links are the actual keywords that are used.

Immunization Exemption Form

Vaccine Exemption Form

Immunization Waiver

Employment:

Most of these are the Hepatitis B vaccine declination forms, such as the OSHA form. There are hundreds of these forms. Rather than linking to each one, here are the Google Search results for these keywords. There are other vaccines that one can decline that are worded like the OSHA forms.

Vaccine Declination Form
or
Hep B vaccine waiver
or
HBV Vaccine Declination Statement

TB and/or Lead Testing

TB-Links/Exemptions

Generic letter for Exemption to TB Testing:
HTML (text): Exemption-tb-test.html

MS Doc file: Exemption-tb-test.doc

OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."

TB Test:


Required by McPherson College
Required by Emporia State University
Required by Bethel College
Required by Ottawa University
Required by Sterling College
Required by Kansas City Kansas Community College for health related fields.
Required by University of Kansas Medical Center

65-129e
Chapter 65.--PUBLIC HEALTH
Article 1.--SECRETARY OF HEALTH AND ENVIRONMENT, ACTIVITIES
      65-129e. Tuberculosis evaluation requirements for certain students; rules and regulations; evaluation criteria; treatment and monitoring of infected persons.
(a) The secretary of health and environment is hereby authorized and directed to adopt rules and regulations establishing tuberculosis evaluation requirements for certain students entering college or university classrooms in Kansas having been born in or lived or traveled in countries identified by the centers for disease control and prevention as areas where tuberculosis is a health risk. Compliance with these rules and regulations, including all cost associated with the evaluation, shall be the joint responsibility of the educational institutions and the student or the parents or guardians of the student, where applicable. These rules and regulations shall establish evaluation criteria in compliance with best practice standards as recommended by the division of tuberculosis elimination of the centers for disease control.

      (b)   Any person found to be infected with tuberculosis infection or tuberculosis disease will be provided treatment and ongoing monitoring in accordance with K.S.A. 65-116a to 65-116m, inclusive, and amendments thereto.

      History:   L. 2005, ch. 122, § 5; Apr. 21.

______________________________________________________


SUBJECT:  Tuberculin Testing of Residents and Employees in Adult Care Homes Licensed as Nursing Facilities, Assisted Living Facilities and Residential Health Care Facilities.

K.A.R. 28-39-161 (b) (3)
K.A.R. 28-39-253 (b) (7)
K.A.R. 28-39-288 (b) (6)
K.A.R. 28-39-433 (b) (7)
42 C.F.R. 483.460 (a) (3) (10)
42 C.F.R. 483.470 (l) (4)

4.      If an employee refuses the skin tests, the employee must be examined by a physician for tuberculosis. This examination should include a chest x-ray. The results of this examination must be documented in the employee record. Additional x-rays are not required unless employee develops symptoms of tuberculosis.

5.      Residents who refuse the skin tests must be examined for tuberculosis by their physician and the results of this examination must be documented in the clinical record within 30 days of admission. A chest x-ray should be included in the examination. Additional x-rays are not required unless the resident develops symptoms of tuberculosis.
Pages 53 – 54
(.pdf) http://www.kdheks.gov/bhfr/download/Reg_Interp_02.pdf
TB and Lead Testing Links:
F L Y E R    LETTER    Exemption_Letters    OSHA_and_TB_test    Tubersol    Treatment    TB_Screening    Alternatives/QuantiFERON_TB_Gold_testimony

The above TB and Lead exemption letters are courtesy of Deirdre DeVane of Wash DC. Thank you Deirdre!
The adult TB letters were edited by Sherri Tenpenny. Thank you Sherri!

TB can be detected by biofeedback machines that are hooked up to a computer, such as the QXCI, Best BioMeridian MSAS (Meridian Stress Assessment) or Electro Dermal Screening, Quantum Life System, and the F-Scan. You will need to ask specifically for a pathogen scan, especially TB. You will also need to request a printout with the results.

Here are some of the practitioners for Kansas

Kansas BEST™ BioMeridian Practitioners:

Please call contact below to find BioMeridian practitioners in your area or closeby.

Oksana Gorodetsky
Marketing/Administrative Coordinator
BioMeridian International
12411 South 265 West, Suite F
Draper, UT 84020
T 801-501-7517
F 801-501-7518
Toll Free 888-224-2337
ogorodetsky@biomeridian.com

Kansas QXCI Practitioners:
Web Archive Link


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