OH Legal Immunization Exemption 2003 free printable template

STATE OF OHIO LEGAL IMMUNIZATION EXEMPTION Per OHIO STATUTE 3313.671 (EXEMPTIONS) Student: School: City: AS LEGAL PARENT(S)/GUARDIAN(S): name(s) I/WE HEREBY WITHDRAW my/our CONSENT to have my/our

How to fill out OH Legal Immunization Exemption

How to fill out OH Legal Immunization Exemption

1. Obtain the Ohio Legal Immunization Exemption form from your healthcare provider or school.
2. Read the instructions on the form carefully.
3. Fill in your personal information, including your name, address, and date of birth.
4. Indicate the type of immunization exemption you are applying for (medical, religious, or philosophical).
5. If it's a medical exemption, provide supporting documentation from a licensed healthcare professional.
6. If it's a religious or philosophical exemption, provide a written statement explaining your beliefs.
7. Sign and date the form.
8. Submit the completed form to your school or healthcare provider as per their instructions.

Who needs OH Legal Immunization Exemption?

1. Individuals seeking an exemption from mandatory vaccinations due to medical, religious, or philosophical reasons.
2. Parents or guardians of minors who wish to exempt their children from school immunization requirements.
3. Those who are enrolled or plan to enroll in educational institutions in Ohio.

People Also Ask about

What is the Ohio Revised Code for Religious Exemption from Vaccine?

Section 3313.671, part (3): A pupil who presents a written statement of his parent or guardian in which the parent or guardian objects to the immunization for good cause, including religious convictions, is not required to be immunized.

What are the exemptions for vaccine in the state of Ohio?

Ohio is among the easiest states for families to opt their children out of the immunizations required for school, offering parents the chance to submit written statements opposing vaccinations for religious and/or personal moral objections.

Can you opt out of vaccines in Ohio?

Ohio Allows Vaccine Exemptions for K-12. The state of Ohio has 3 types of exemptions: Medical and Reasons of Conscience, including Religious convictions. Medical exemptions require a signature from a licensed physician in the state of Ohio.

Does Ohio have vaccine exemptions?

While 44 states and Washington, D.C. allow religious exemptions for vaccinations, Ohio is among 15 states to go a step further and allow personal philosophy exemptions. All state immunization laws grant exemptions to children for medical reasons, ing to the National Conference of State Legislatures.

Is there a religious exemption in the Ohio Revised Code?

Nothing in section 945.01 of the Revised Code shall be construed to prohibit, abridge, or in any way hinder the religious freedom of any person or group.

What is the Ohio Revised Code for vaccination exemption?

per Ohio Revised Code § 3313.671 Ohio Revised Code Section 3313.671(B)(5) states that a child whose physician certifies in writing that such immunization against disease is medically contraindicated is not required to be immunized against that disease.

For pdfFiller’s FAQs

What is the purpose of ohio vaccine exemption form?

The Ohio Vaccine Exemption Form is used to provide parents or guardians of school-aged children with the ability to request an exemption from the state's immunization requirements. The form is used to request an exemption due to medical, religious, philosophical, or moral reasons.

What is ohio vaccine exemption form?

The Ohio vaccine exemption form, also known as the Ohio Certificate of Exemption from Immunization, is a document that allows individuals in Ohio to be exempted from certain required vaccinations. This form can be used for religious, medical, or philosophical reasons for exemption. It must be completed and signed by a parent or legal guardian if the exemption is requested for a child. The completed form needs to be submitted to the child's school or child care center to waive the vaccination requirement. It is important to note that exemptions may have limitations and can vary depending on local regulations and individual circumstances.

Who is required to file ohio vaccine exemption form?

In Ohio, parents or guardians of children attending school or childcare institutions are required to complete the Ohio Vaccine Exemption Form if they want to exempt their child from receiving certain vaccinations due to medical, philosophical, or religious reasons.

How to fill out ohio vaccine exemption form?

To fill out the Ohio vaccine exemption form, follow these steps: 1. Download the "Ohio Department of Health - Vaccine Exemption Form" from the official Ohio Department of Health website. The form is titled "JFS 01698 - Vaccine Exemption Request." 2. Open the downloaded form using a PDF reader software. 3. Begin by providing the requested information at the top of the form, including the child's full name, date of birth, and county of residence. 4. Next, you need to select the type of exemption you are seeking. Tick the checkbox next to the appropriate exemption type: - Medical exemption: Select this if a licensed physician or nurse practitioner has determined that the vaccination would be medically harmful for the child or a family member. - Religious exemption: Choose this if receiving the vaccination conflicts with your religious beliefs or practices. - Reasons of conscience exemption: Select this if you have a personal objection to vaccines for reasons of conscience. 5. After selecting the appropriate exemption type, provide additional requested information, such as the date of the exemption request, your name, and relationship to the child. 6. Read and acknowledge the consequences of choosing an exemption by checking the box provided. 7. Complete the "Medical and Religious Reasons Section" or the "Reasons of Conscience Section" depending on the exemption type you selected. a) For a medical exemption: - Provide a detailed explanation of the specific medical condition or reasons for which the child cannot be vaccinated. - Attach a signed statement from a licensed physician or nurse practitioner supporting the medical exemption. b) For a religious exemption: - Provide a detailed explanation of how vaccination contradicts your religious beliefs or practices. c) For a reasons of conscience exemption: - Provide a detailed written statement explaining the reasons why you object to vaccination on personal grounds. 8. Sign and date the form at the bottom. 9. Make a copy of the completed form for your records. 10. Submit the form to the appropriate authorities as mentioned on the form. This may vary depending on your location, so refer to the instructions provided on the form. Please note that it is advisable to consult with a healthcare professional or legal expert for further advice and guidance specific to your situation when considering a vaccine exemption.

What information must be reported on ohio vaccine exemption form?

The specific information required on a vaccine exemption form in Ohio can vary depending on the type of exemption being sought. However, generally, the following information may be requested: 1. Student information: This includes the name, address, date of birth, and grade/level of education of the student requesting the exemption. 2. Parent or guardian information: The form may require the name, address, phone number, and signature of the parent or legal guardian. 3. Reason for exemption: The form may ask for a detailed explanation of the reason for seeking the exemption. This could include religious objections, medical contraindications, or philosophical beliefs. 4. Supporting documentation: Depending on the nature of the exemption, additional documentation may be required. For religious exemptions, a statement or letter from a religious authority or leader may be necessary. For medical exemptions, relevant medical records or a doctor's note may be requested. 5. Confirmation of understanding: The form may include a section where the parent or guardian confirms that they understand the risks associated with not vaccinating and waive any liability on the part of the school or health department. It's important to note that this is a general overview, and the specific details and requirements may vary depending on the county or school district in Ohio. It is recommended to consult the relevant school or health authorities to obtain the exact requirements for vaccine exemption in a particular jurisdiction.

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What is OH Legal Immunization Exemption?

OH Legal Immunization Exemption refers to a legal provision that allows individuals to opt out of certain immunization requirements for medical, religious, or philosophical reasons in Ohio.

Who is required to file OH Legal Immunization Exemption?

Parents or guardians of children who are subject to immunization requirements in Ohio are required to file the OH Legal Immunization Exemption.

How to fill out OH Legal Immunization Exemption?

To fill out the OH Legal Immunization Exemption, individuals must complete a specific form provided by the state, indicating the reason for exemption and providing any necessary supporting documentation.

What is the purpose of OH Legal Immunization Exemption?

The purpose of the OH Legal Immunization Exemption is to allow individuals to refuse vaccinations based on personal beliefs, and to ensure that their rights are protected while still promoting public health.

What information must be reported on OH Legal Immunization Exemption?

The OH Legal Immunization Exemption must include details such as the individual's name, the child's name, the specific immunizations being exempted, and the reason for the exemption.