Religious Exemption Letter Printable Immunization Exemption Form
Nc Immunization Exemption Form. Web (08/03/2020)revised medical exemption statement and physician’s request for medical exemption forms memo; Retain a copy for the patient’s file.
Religious Exemption Letter Printable Immunization Exemption Form
Learn more about these exemptions, and the process for requesting an exemption for your children. Attach a copy of the most current immunization record. Submission of certificate to college or universities. Both of these exemptions require a signature by a physician in north carolina. Restitution required when vaccine spoiled due to provider negligence. They are medical and religious. Web (08/03/2020)revised medical exemption statement and physician’s request for medical exemption forms memo; Web the state health director may, upon request by a physician licensed to practice medicine in this state, grant a medical exemption to a required immunization for a contraindication not on the list adopted by the commission. Physician’s request for medical exemption (pdf, 136 kb) (dhhs 3995) To provide physicians licensed to practice medicine in north carolina, a mechanism to certify, pursuant to g.s.
Web instructions complete and sign the form. Web north carolina law provides for two types of exemptions from required immunizations. Retain a copy for the patient’s file. The state also allows exemptions based on “bona fide religious beliefs.” it does not, however, grant. Submission of certificate to college or universities. Both of these exemptions require a signature by a physician in north carolina. Web like all states, north carolina provides for medical exemptions from immunizations. Medical exemptions for required immunizations will only be granted upon submission of either a medical exemption statement (dhhs 3987) or physicians request for medical exemption (dhhs 3995). Physician’s request for medical exemption (pdf, 136 kb) (dhhs 3995) Web instructions complete and sign the form. To provide physicians licensed to practice medicine in north carolina with a mechanism to request a medical exemption to a required immunization(s), pursuant to g.s.
