Option 1. Online Form
Complete online non-medical exemption form
Option 2. Paper Form
- Download and print paper non-medical exemption form below.
- Complete and sign the form
- Mail to the address below or scan/photograph and submit via upload.
Option 3. Your Statement
- Write your own statement of exemption, including the following:
- student’s full name
- age or date of birth
- date the exemption was filed
- the immunizations declined
- which type of non-medical exemption is being taken (personal belief or religious)
- signature of the child’s parent or legal guardian