Arkansas Vaccine Exemption Form. The person requesting the shot record must be a responsible party on record. Arkansas law requires all students attending arkansas schools and licensed childcare facilities to be vaccinated against certain diseases, unless an official exemption form is filed.
A physician statement outlining medical reasons for an exemption of a specific immunization is to be submitted to the medical director of the communicable disease/immunization section with the exemption form. I have read the vaccine information statement and understand by not receiving the tdap vaccine, the student listed here is at risk of pneumonia, whooping cough, seizures, inflammation of the brain, serious neurological complications, and death. The application may be completed by parents or guardians of students or by students who are 18 years of age or older. Web you must print the immunization exemption form, then sign, notarize, and return it to the immunization program in order to complete your immunization exemption. Web arkansas administrative rules 005.15.010 immunization requirements 5.03 religious exemptions 5.03.4 in addition to the general requirements found in section 5.01, the department of health, immunization section's standard form for religious exemptions must be submitted to the immunization section. The person requesting the shot record must be a responsible party on record. Dtap hib hepatitis a hepatitis b measles, mumps, & rubella meningococcal acwy pneumococcal conjugate (pcv13) polio td (tetanus,. You can also visit the local health unit in your county note: An application requesting an exemption must be submitted for each child or student. How do i get a medical exemption for my child to not get an immunization?
Web this website allows you to submit an application for exemption. You can also visit the local health unit in your county note: Arkansas law requires all students attending arkansas schools and licensed childcare facilities to be vaccinated against certain diseases, unless an official exemption form is filed. Dtap hib hepatitis a hepatitis b measles, mumps, & rubella meningococcal acwy pneumococcal conjugate (pcv13) polio td (tetanus,. The application may be completed by parents or guardians of students or by students who are 18 years of age or older. Web this website allows you to submit an application for exemption. Web you must print the immunization exemption form, then sign, notarize, and return it to the immunization program in order to complete your immunization exemption. Web by checking the box below, i am requesting an exemption from this vaccine. A physician statement outlining medical reasons for an exemption of a specific immunization is to be submitted to the medical director of the communicable disease/immunization section with the exemption form. Web shot record request form: How do i get a medical exemption for my child to not get an immunization?
