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EXEMPTION FROM IMMUNIZATIONS DECLARATION Student Health Services P.O. Box 43692 Lafayette, LA 705043692 Phone: (337) 4821293 Fax: (337) 4821872 Name: ___Date of Birth: ___LID: ___Semester/Year Enrollment:
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What is immunization exemption form louisiana?
The immunization exemption form in Louisiana is a document that allows individuals to request an exemption from the required immunizations for school enrollment or other purposes based on medical, religious, or philosophical reasons.
Who is required to file immunization exemption form louisiana?
Parents or guardians of children who are attending school or childcare in Louisiana and wish to exempt their children from vaccination requirements must file the immunization exemption form.
How to fill out immunization exemption form louisiana?
To fill out the immunization exemption form, individuals must provide personal information including the child's name, date of birth, and the specific reason for the exemption. It may require a signature and, in some cases, supporting documentation.
What is the purpose of immunization exemption form louisiana?
The purpose of the immunization exemption form in Louisiana is to formally recognize an individual's right to refuse certain vaccinations for their children while ensuring that the educational institutions are aware of the immunization status.
What information must be reported on immunization exemption form louisiana?
The form typically requires the child's full name, date of birth, the specific immunization(s) being exempted, the reason for the exemption (medical or religious), and the signature of the parent or guardian.
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