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What information will be listed on the vaccine exemption affidavit form I receive?

Affidavit form vaccine
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What information will be listed on the vaccine exemption affidavit form I receive?

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A. Information on the form will include the child’s name; date of birth; a list of vaccines for which exemptions may be requested; a statement for the requesting parent or guardian to indicate their relationship to the child; and an acknowledgement that the parent or guardian has read attached information entitled The Benefits and Risks of Vaccinations. Parents or guardians will then have to sign the form in front of a notary public.

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