Get the free Immunization Exemption Form, Louisiana Requirements 08232021

Medical and NonMedical Exemption Louisiana Vaccine Requirements Louisiana R.S. 17:170/Schools of Higher LearningName: Semester of Enrollment: Fall Spring Summer 20 Please Print(Last)(First)(M.I.)

How to fill out immunization exemption form louisiana

How to fill out immunization exemption form louisiana

1. To fill out the immunization exemption form in Louisiana, follow these steps:
2. Obtain a copy of the immunization exemption form from your child's school or the Louisiana Department of Health website.
3. Fill in your child's personal information, including their name, date of birth, address, and school.
4. Provide a reason for the exemption. In Louisiana, acceptable reasons for exemption include medical contraindication, religious belief, or philosophical or moral convictions.
5. If claiming a medical exemption, attach a statement signed by a licensed healthcare provider explaining why immunization is contraindicated for your child.
6. If claiming a religious exemption, provide a signed and notarized affidavit stating your religious beliefs or practices that conflict with immunization.
7. If claiming a philosophical or moral exemption, provide a signed and notarized affidavit explaining your philosophical or moral objections to immunization.
8. Date and sign the form.
9. Submit the completed form to your child's school or the Louisiana Department of Health, as instructed.

Who needs immunization exemption form louisiana?

1. Anyone who wishes to exempt their child from immunization requirements in Louisiana needs to fill out the immunization exemption form.
2. This includes parents or legal guardians who have medical contraindication, religious beliefs, or philosophical or moral objections to immunization for their child.
3. However, please note that exemptions may be subject to review and approval by the Louisiana Department of Health.

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What is immunization exemption form louisiana?

Immunization exemption form Louisiana is a document that allows individuals to exempt themselves or their children from immunization requirements for specific reasons, such as medical, religious, or personal beliefs.

Who is required to file immunization exemption form louisiana?

Individuals or parents/guardians of children who wish to exempt themselves or their children from immunization requirements in Louisiana are required to file the immunization exemption form.

How to fill out immunization exemption form louisiana?

To fill out the immunization exemption form in Louisiana, individuals need to provide their personal information, reason for exemption (medical, religious, or personal belief), and signature. The form must be submitted to the appropriate authorities for approval.

What is the purpose of immunization exemption form louisiana?

The purpose of the immunization exemption form in Louisiana is to provide individuals with the option to exempt themselves or their children from immunization requirements based on medical, religious, or personal belief reasons.

What information must be reported on immunization exemption form louisiana?

Information such as personal details, reason for exemption, signature, and any supporting documentation must be reported on the immunization exemption form in Louisiana.