Non-Medical Exemption

Option 1. Online Form
Complete online non-medical exemption form

Option 2. Paper Form

  1. Download and print paper non-medical exemption form below.
  2. Complete and sign the form
  3. Mail to the address below or scan/photograph and submit via upload.

Option 3. Your Statement

  1. 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
  2. Mail to the address below or scan/photograph and submit via upload.