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Mad River Local Schools
IMMUNIZATION EXEMPTION FORM
Medical, Religious, and Good Faith Exemptions
Amended Substitute Senate Bill #282, Ohio Revised Code,
Sections 3313.671, Part (3) and (4)
Section
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How to fill out medical religious and good

How to fill out medical religious and good:
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05
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What is medical religious and good?
Medical religious and good exemption is a form that allows individuals to exempt from certain medical procedures or treatments based on religious beliefs or personal convictions.
Who is required to file medical religious and good?
Individuals who wish to be exempt from certain medical procedures or treatments based on religious beliefs or personal convictions are required to file medical religious and good.
How to fill out medical religious and good?
To fill out medical religious and good, individuals need to provide their personal information, explain their religious beliefs or personal convictions that prevent them from certain medical procedures, and sign the form.
What is the purpose of medical religious and good?
The purpose of medical religious and good is to allow individuals to be exempt from certain medical procedures or treatments that conflict with their religious beliefs or personal convictions.
What information must be reported on medical religious and good?
The information that must be reported on medical religious and good includes personal details, explanation of religious beliefs or personal convictions, and signature.
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