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Vaccination Exemptions
California
State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page

Statutes/L A W S
California State specific information

Link to state law.
National Vaccine Information Center:
NVIC link to state law.


For additional help with exemptions, birth plan, etc questions:
Check our Vaccination Liberation State Chapter and other resource organizations located in your state.

If your state specific help is not available, Contact us.

California Legislative Website
See section 120335 (g) (1), and (2) for definition of "grade span" and grandfathered exemption filings.
Source: HEALTH AND SAFETY CODE SECTION 120325-120380

SB-277 Public health: vaccinations (Modifications of above sections that became Effective January 1, 2016)

Per NVIC website above:
In 2011 AB-499 Minors: medical care: consent was passed which allows minors 12 years old and older to consent to vaccines for sexually transmitted diseases without the knowledge or consent of their parents. This includes HPV vaccine.

Religious (or Personal Belief) Exemptions have been eliminated except as mentioned in next paragraph.
Alerts: California Vaccine Exemptions
Reference to SB277:
Note that the Following facts are important:
Application began January 1, 2016
Does not apply to home-based private school
Does not apply to students enrolled in an independent study program and who do not receive classroom-based instruction...
Exemptions filed prior to January 1, 2016 remain in effect until the student changes grade span.
(2) For purposes of this subdivision, “grade span” means each of the following:
  (A) Birth to preschool.
  (B) Kindergarten and grades 1 to 6, inclusive, including transitional kindergarten.
  (C) Grades 7 to 12, inclusive.

SB277 does not prohibit a student who qualifies for an individualized education program (“IEP”) from accessing special education and related services required by his or her IEP.

M O R E on California Law
Calif Code snips    |    Summary/List of commonly used links

Richard Jaffe, Esq. , Lawyer provides some answers
Now That SB 276 And SB 714 Are Law, What Does It All Mean For Parents? - September 10, 2019

Caesar Has Spoken! The Cali. Department of Public Health Provides Answers to (Some of) Your Questions about Vaccine Medical Exemptions
September 23, 2019



- - - Available Exemptions - - -
Medical Only!


New filings of Personal Beliefs Exemption (PBE) have been eliminated with exception of vaccines added to the current recommendations. See section 120338.

Important:
July 1, 2011 a new Tdap booster vaccine is required to enter California schools, grades 7-12.


CA law snips - Quicklinks
EDUCATIONAL AND CHILD CARE FACILITY IMMUNIZATION REQUIREMENTS ... 120325-120380 (Until January 2016)
120325.
   (c) Exemptions from immunization for medical reasons.

120360. The requirements of Chapter 1 (commencing with Section 120325, but excluding Section 120380) and of Sections 120400, 120405, 120410, and 120415 shall not apply to any person 18 years of age or older, or to any person seeking admission to a community college.

(Added by Stats. 1995, Ch. 415, Sec. 7. Effective January 1, 1996.)



124116.5. Newborn And Infant Hearing Screening
(d) This section shall not apply to any newborn whose parent or guardian objects to the test on the grounds that the test is in violation of his or her beliefs.
https://leginfo.legislature.ca.gov...

124116.5 (d) This section shall not apply to any newborn whose parent or guardian objects to the test on the grounds that the test is in violation of his or her beliefs.


CHAPTER 2. Tuberculosis Tests for Pupils [121475 - 121520]
121475.
(c) Exemptions from tuberculosis tests because of personal beliefs.
https://leginfo.legislature.ca.gov/...


Newborn Eye Pathology Screening .... 124111-124112
HEALTH AND SAFETY CODE SECTION
124112(d) Any screening examination recommended pursuant to subdivision (a) shall not be conducted on a newborn if a parent or guardian of the newborn objects to the examination on the grounds that the examination conflicts with the religious beliefs or practices of the parent or guardian.

Newborn Screening ... 125000-125002
[phenylketonuria and other preventable heritable or congenital disorders]
125000.
   (d) This section shall not apply if a parent or guardian of the newborn child objects to a test on the ground that the test conflicts with his or her religious beliefs or practices.

Prenatal Testing ... 125050-125119.5
125110. The Maternal and Child Health Program Act (Section 27) shall not apply if the pregnant woman objects to the test required by that act on the ground that the test conflicts with her religious beliefs or practices.
Summary of commonly used forms
and links to State Regulations.
California Immunization Handbook - EZIZ & School Vaccination Requirements K-12:
http://eziz.org/assets/docs/shotsforschool/IMM-365.pdf


How to Claim a Medical Exemption in CA
http://www.westonaprice.org/health-topics/vaccination/how-to-claim-a-medical-exemption-in-ca/

Guide to Immunizations Required for School Entry - EZIZ
http://eziz.org/assets/docs/IMM-231.pdf


CHAPTER 2. Tuberculosis Tests for Pupils [121475 - 121520]
121475.
(c) Exemptions from tuberculosis tests because of personal beliefs.
https://leginfo.legislature.ca.gov/...

California Immunization Handbook - EZIZ
California does not have a state exemption form for college students. Ask the college for an exemption form. If they do not have one write a letter or affidavit stating the vaccine is against your beliefs. See page D-76 of
Vaccination Record Form: http://www.eziz.org/assets/docs/IMM-75LK.pdf
[The link at the top of this paragraph]
A few colleges have their forms online, Click here.

State Dept of Health Link
(Vaccination Program https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/immunize.aspx



Immunization Requirements for K-12

Includes Tdap booster shot requirement for 7th through 12th grade students.
http://eziz.org/assets/docs/IMM-1080_School.pdf

AB499 was passed and signed by Governor Brown. The new law allows minors 12 years old and older to consent to vaccines for sexually transmitted diseases without the knowledge or consent of their parents. This includes HPV Vaccine and any vaccines approved in the future.
http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_0451-0500/ab_499_bill_20111009_chaptered.html

SECTION 1. Section 6926 of the Family Code is amended to read:
6926. (b) A minor who is 12 years of age or older may consent to medicalcare related to the prevention of a sexually transmitted disease.
State Immunization Tracking System info:
http://cairweb.org/


Immunization Tracking System opt out eliminated:
... under Health and Safety Code 120440, recently amended by AB 1797, all administered vaccines are required to be submitted.
FAQ: https://www.cdph.ca.gov/

It's your legal right to ask: Patients who decline immunization sharing
http://cairweb.org/ [PDF]

If patients do not want their immunization record being shared with other CAIR or RIDE/Healthy Futures providers, they must download, complete and fax the Decline to Share or Start Sharing Immunization Information Request lock/unlock forms to the CAIR Help Desk at 888-436-8320.Feb 9, 2023


Updates/News

No Recent Updates to Report


Related Pages

Finding Physicians friendly to non-vaccination or alternate schedules


red pill Your Choice.
Join thousands of other pioneers in refuting the presumed authority the corporate government has over your life.
Break the presumptions by negating adhesion contracts. Find out if your state's corporate statutes actually apply to you. Did you sign a contract binding you to adhere to their statutes? Not likely. To learn more, go to this page.
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PDF documents (.pdf)

A PDF reader is required for PDF Files:
Free Foxit Reader 5 MB file size.

Or Free Download of Acrobat Reader: [Adobe. 43 MB file size]

Other Website Information Links


Should Any Vaccines Be Required for Children?
Pro Claims vs Anti Claims

History of Vaccines

Table of State Vaccination Exemptions for Children Entering Public Schools

Page Navigation Links

Begin New Born Birthing Plan and Birth Exemptions
California State specific New Born Exemption Information.

Religious Exemption from newborn screening allowed. Cal. Health & Safety Code § 125000

Cal. Health & Safety Code § 125000(d)
(d) This section shall not apply if a parent or guardian of the newborn child objects to a test on the ground that the test conflicts with his or her religious beliefs or practices.

https://codes.findlaw.com/ca/health-and-safety-code/hsc-sect-125000.html

Newborn Eye Pathology Screening .... 124111-124112
HEALTH AND SAFETY CODE SECTION
124112(d) Any screening examination recommended pursuant to subdivision (a) shall not be conducted on a newborn if a parent or guardian of the newborn objects to the examination on the grounds that the examination conflicts with the religious beliefs or practices of the parent or guardian.


Newborn Screening ... 125000-125002
[phenylketonuria and other preventable heritable or congenital disorders]
125000.
   (d) This section shall not apply if a parent or guardian of the newborn child objects to a test on the ground that the test conflicts with his or her religious beliefs or practices.


Prenatal Testing ... 125050-125119.5
125110. The Maternal and Child Health Program Act (Section 27) shall not apply if the pregnant woman objects to the test required by that act on the ground that the test conflicts with her religious beliefs or practices.


NewBorn Birthing Plan CONTINUED  [GENERAL INFORMATION APPLIES TO MOST STATES.]

BirthExemptions  |   Birthing_Plans  |   Vitamin_K  |   Hepatitis_B  |   Eyedrops  |   Newborn_Screening

Birth Exemptions:

For those who are planning a hospital birth but want to evade invasive routine post natal procedures such as a Hep B shot, vitamin K injection, newborn screening, or the application of silver nitrate in the newborn's eyes, a very specific birthing plan must be submitted to the hospital in advance of the birth. Hospital staff must be informed, in advance, of your needs, wants and desires where your baby and birthing experience are concerned. The same applies to midwives.

Steps:



  • Create the Birthplan. Or modify one of our ours to fit your state laws and any other personal circumstances. (see below)
  • Sign the birthplan in front of a Notary.
  • Submit the birth plan to your hospital or midwife. Keep a couple extra copies in case plans change.
  • Make sure affected parties (doctors, nurses, etc) understand your requirements and wishes.
  • Plan on having one or two trusted persons stay with the mother and child to watch the child at all times while in the hospital, so no unwanted injections are given the baby.
  • The birth plan arrangements and letter should be turned in before delivery date.
  • The "Refusal to Permit Medical Treatment" form below is optional.
  • The "Refusal to Register Live Birth" form below is also optional.



California State specific information Birth Plans
None at this time.


Birth Plans GENERAL INFORMATION
(To be used with hospitals and/or midwives)


(Links to model birth plan letters)

Model Birth Plan Letter for Hospital Births. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc...



Information on the Dangers of Hospital Birth and the Benefits of Home Birth from gentlebirth.org

Our best and most itemized birthplan:
Word-Document (.doc) birthplan-itemized.doc  |   PDF-Document (.pdf) birthplan-itemized.pdf

(HTML) BirthPlan-Itemized for reading on screen. Includes handy small dictionary of terms in the document.

Word-Document (.doc) Model Letter for Hospital Births (Model11425.doc)

Model Birth Plan Letter for Hospital Births. This one is more detailed.

Word-Document (.doc) Model letter for hospital births 2.doc (11426)

Model Birth Plan Letter for Hospital Births for an adopted child...
Model letter for hospital births for adoptions -- Dear Doctor and Medical Staff.doc (11427)
Word-Document (.doc) Model letter for hospital births for adoptions.doc


The birth plan arrangements and letter should be turned in before delivery date.
This "Refusal to Permit Medical Treatment" form below is optional.




California State specific information Medical Treatment Refusal
None at this time.


GENERAL INFORMATION (Medical Refusal Forms and Affidavit)




"Refusal to Permit Medical Treatment" form
A generic form.
PDF-file (.pdf) letters/refusal_treatment.pdf


It would be good idea to use the AFFIDAVIT below AND a model birth plan letter from above above.
Affidavit - Birth Exemptions
HTML (simple text) Affidavit to modify.

AFFIDAVIT in Microsoft Word Word-Document (.doc) format. (may be modified)

If your Title and Paragraph number of your state law is not pasted to the left, click here for the link to your state law.

Affidavit: Definition and some terms.




California State specific information Vitamin K
VITAMIN K ADMINISTRATION: Every neonate should receive a single parenteral 0.5-1.0 mg dose of vitamin K oxide or phytonadione (AquaMEPHYTON®) within 1 hour of birth for prevention of vitamin K deficiency bleeding (Hemorrhagic Disease of the Newborn). Occasionally parents will refuse vitamin K or request oral administration.
If parents persist in their refusal, they must sign the "Refusal to Permit Medical Treatment" form. These forms are kept in the file cabinet behind the unit clerk's desk in the WBN.



Summary:

1. Make an informed choice as far ahead of birth as possible.

2. See the Black box warning in the FDA Package Insert for the Injection.

3. Know your options: Pre-Birth Diet, Oral Vitamin K, or synthetic Vitamin K Injection.


GENERAL INFORMATION
Vitamin K



Vitamin K Injection...

The Question of Vitamin K for Newborns
"Essentially all human infants are born with very low blood levels of vitamin K and, since low amounts of vitamin K crosses into breast milk, levels remain low for several weeks after birth in breastfed babies. The purpose of this natural, universal experience of low vitamin K levels in newborns is not known. ..."
"Mouse and epidemiologic studies indicate that the neonatal “deficiency” of vitamin K, which promotes cell turnover, may actually protect the developing fetus from damaging substances that “escape the primary placental screen.”
Read the rest of the article here:
http://www.thevaccinereaction.org/

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.

Warning

"The injectable form of vitamin K can rarely cause severe (sometimes fatal) allergic reactions when given by injection into a muscle or vein. Therefore, vitamin K should be injected into a muscle or vein only when it cannot be given by injection under the skin or taken by mouth, or when your doctor has judged that the benefit is greater than the risk. Seek immediate medical attention if you experience symptoms of an allergic reaction such as rash, itching, swelling, dizziness, or trouble breathing."
Potential exists for the newborn to experience hypersensitivity to any component of this medication.
Each milliliter contains: Phytonadione .. 2 mg or 10 mg
Inactive ingredients:
Polyoxyethylated fatty acid derivative .... 70 mg
Dextrose................................... 37.5 mg
Water for Injection, q.s. .................. 1 mL
Added as preservative: Benzyl alcohol .... 0.9%

Links to prescribing information for Vitamin K:
AquaMEPHYTON - FDA [PDF] 2002 PDF

http://vaclib.org/

Archive: Year 2002 Merck Vitamin K Package Insert - Aquamephyton PI | posted on Scribd

My daughter's Vitamin K injection injury Chairwoman and all ...
One Woman's experience: [PDF]

Alternatives to Vitamin K Prophylaxis...

Although oral vitamin K is not licensed for use as a drug by the FDA, drops for oral administration are available. Typically, one drop contains 2 mg. of vitamin K. Contact a midwife in your area, or a birthing supply company (such as birthwithlove.com), or Scientific Botanicals (206 527-5521) where your health care provider can order liquid vitamin K directly.

Here's another much safer alternative that your chiropractor or naturopath can order for you.

http://www.bioticsresearch
.com/Products/BioK.htm


Or buy direct from Amazon.com:

Good article with links to sources of oral and natural vitamin K
http://www.thehealthyhomeeconomist.com/oral-vitamin-k-better-vitamin-k-shot/

A good organic whole food diet along with lots of leafy green vegetables is all that is necessary to prevent vitamin K deficiency in newborns.

More Information:
Daily Med - Package Insert:
http://dailymed.nlm.nih.gov/

VRM: First Strike – The Dark Side of The Vitamin K Shot
http://vaccineresistancemovement.org/?p=6547

Informed Consent Defense (2020 Pilot Survey)
Wonderful Graphs comparing various unvaccinated vs vaccinated disease rates for vaccines and Vitamin K at birth PDF 4.8MB




California State specific information Hepatitis B
None at this time.

Hepatitis B Vaccine




Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in by asking hospital personal to sign the following waiver. Usually, you'll never find anybody in the hospital to sign this simple form, but you well get relief from demands to vaccinate your child.

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

See Birth Plans for more information on avoiding Hep B Vaccination at birth




California State specific information Eyedrops
EYE PROPHYLAXIS against gonococcal opthalmia neonatorum is mandatory for all neonates. A 1-2cm ribbon of sterile ophthalmic ointment containing 0.5% erythromycin should be administered within 1 hour of birth. Although California state law mandates neonatal eye prophylaxis, parents who refuse may sign a special waiver. This form is entitled "Refusal to Allow Treatment of Eyes of Infant with Prophylactic-Efficient Agent" and is located in the cabinet behind the unit clerk's desk in the WBN.


Eyedrops: General





Some states require Prophylaxis against Gonococcal OPHTHALMIA NEONATORUM.

A discussion of medical and legal issues regarding Silver Nitrate in the eyes of the newborn is here:
PDF file: Statutory Law USA: Requiring Silver Nitrate in Eyes of Newborns at: http://www.rbs2.com/SilvNitr.pdf
Written by Dr. Ronald B. Standler, attorney in Massachusetts and consultant

Blog type discussion of pros and cons of eyedrops for newborn is here: http://answers.google.com/answers/threadview/id/20050.html





California State specific information New Born Screening
The Genetic Disease Screening Program (GDSP)
Notice of Information and Privacy Practices (CDPH)
https://www.cdph.ca.gov/Programs/CFH/DGDS/Pages/nbs/nbsnpp.aspx

124116.5. Newborn And Infant Hearing Screening
(d) This section shall not apply to any newborn whose parent or guardian objects to the test on the grounds that the test is in violation of his or her beliefs.
https://leginfo.legislature.ca.gov...

124116.5 (d) This section shall not apply to any newborn whose parent or guardian objects to the test on the grounds that the test is in violation of his or her beliefs.



New Born Screening: General




U.S. states now require screening of newborn babies for specific diseases.

Conditions and legal status of "requirement" of newborn to be screened for each state:
National Newborn Screening Status Report

Newborn Genetic Screening Privacy Laws
(includes links to laws for various states)
Archived Copy:

Newborn screening From Wikipedia, the free encyclopedia
en.wikipedia.org/

Federal NewBorn Screening Law
ncbi.nlm.nih.gov/


Page Navigation Links


Waivers: Read - Modify or Do Not Sign
California State specific information Waivers
None at this time.

Waivers - Take Care In Signing
If you take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware of and careful of any forms you sign.

Our WARNING below is about signing (some) state approved and AAP created forms. See this letter from our director, Ingri Cassel, before you consider signing waiver forms.



WARNING!

To ALL who choose to partially vaccinate or NOT vaccinate their children:

We (here in Idaho) are hearing more reports of schools and daycares across our state not honoring legal and valid vaccine exemptions. The following article contains very important information as to why you do NOT want to sign AAP's (state adopted) exemption form: http://childhealthsafety.wordpress.com/ ...

Filing a NO Vaccination Notice – for patients, employees and students (Your_Choice)

Older letter regarding exemptions in Idaho (similar to many states today)

Dear VacLib Members and Friends -

Wanted to give you all a heads up on state issued exemption forms. I haven't had to deal with this personally for several years, and I always crossed out sentences or clauses, and often adding some of my own, before signing their exemption of medical release type of forms. When Donna Carrillo began to diligently search out existing exemption forms and posting them, I read over a couple of them and encouraged people to make up their own whenever possible. After having a "closer encounter" with such a form - a form provided to the state of Idaho by the American Academy of Pediatrics and the Centers for Disease Control and Prevention and used by licensed Idaho daycares, I was shocked into the VERY REAL danger of signing these forms without changing them significantly.

Any form one affixes their initials to, dates and affixes their signature to at the end is a LEGAL document. All statements prior to your signature you must agree to fully OR restrict your signature to say that you are signing under TDC - threat, duress, and coercion. The form that my daughter was told she needed to fill out for this daycare is posted here: ChildCareExemptForm.pdf. On this form, she crossed out all the "nots" and in her personal statement she further clarified that she understands fully the risks of vaccinating her child.

I have since found out that most public schools and daycares in other states also use a similar form. Basically, by initialing and signing this form as is, you are admitting to understanding that "vaccine preventable" diseases are extremely deadly and ALSO admitting to negligence for willfully denying your son/daughter the life saving protection that vaccines offer. These forms are MEANT to not only be intimidating but to catch the legally ignorant off guard. This is very serious to me since all states have adopted the federally funded Child Abuse Prevention and Treatment Act which gives states the right to literally steal your children for up to 48 hours -- the time they have to prove child neglect OR abuse.

If it were ME, I would insist that they accept a form that I provide them since it satisfies the law. If there are any problems or they insist on me using their form, I would cite the law and ask the school or daycare provider where it actually says in state statute that this particular form is the only form that will satisfy the law. Since your parental rights are at stake here, it is best to be vigilant and err on the side of being overly cautious.


A modified AAP form is posted here that you may wish to use with your doctor: AAPmodified.htm

AAPmodified.doc MSWord .DOC file  |   AAPmodified.pdf PDF file, best for printing.

Not all State employees are aware of the law and many exhibit the Hitler Complex. Take a firm stand. Some individuals have had difficulty getting the required forms. Such arrogance on the part of State employees should be reported to the Director of your state Department of Health.

See:   AnaiRhoads.org [archive] Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse
She is referring to the Refusal To Vaccinate From developed by The American Academy of Pediatrics, not a regular religious or conscientious exemption letter or form.

Black's Law Dictionary - Sixth Edition - the definition of Affidavit. This is the dictionary used by the American Bar Association and all judges/magistrates/attorneys.

Affidavit - A written or printed declaration or statement of facts, made voluntarily, and confirmed by oath or affirmation of the party making it, taken before a person having authority to administer such oath or affirmation. [notary]

Warning: Any affidavit we supply is a suggestion or template for you to modify to fit your beliefs or understanding of facts. The "facts" are those of the person signing the affidavit.
Some definitions for terms on AFFIDAVIT:

Further Affiant Saith Not

Affiant: a person who makes an affidavit.

Saith: A third person singular present tense of say.

Sui Juris: having full legal capacity to act on one's own behalf : not subject to the authority of another

Propria Persona: In ones own proper person.


Page Navigation Links


California State specific information LETTERS FORMS AFFIDAVITS
None at this time.

Letters Forms Affidavits (General)

Affidavit Index for all Ages: Affidavit Index



Links to Model birth plan letters (above).

Link to Refusal to Permit Medical Treatment form

Links to Affidavit - Birth

An Adult Affidavit, with Christian beliefs, is here. (MSDOC file) Feel free to modify as needed.

Dr. Tenpenny had the following forms on her web site. (Now Archived) The forms are generic and may be used in any state. Check any references that might need updating.

Affidavit for Parents Participating in International Adoption (Word) (pdf)
Hep B vaccine in hospital for newborn refusal, sample (pdf)
OSHA Declination Statement Form (also, pdf)
Religious exemption letter that was approved in Florida (Word) (pdf)
School Vaccine Exemption Form, sample (Word) (pdf)
TB testing refusal, sample (pdf)
Childcare and School Immunization Requirements

web.archive.org

Sample Vaccine Letters. from vaccines.bizland.com/letters.htm archived on VacLib.org/

Short Sample Vaccine Letter

Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in the following manner. (Usually, you'll never find anybody in the hospital to sign this simple form):

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

The ACCEPTANCE OF RESPONSIBILITY is imperative in exercising your rights for legal exemptions from forced medical experimentation and legalized bioterrorism. DO be prepared to fight for your baby's rights!
An index page to various Acceptance of Responsibility) forms is here:
. http://www.vaclib.org/legal/accept.htm

Religious exemption forms will be listed below under Daycare Schools Colleges

Did not find your state exemption form on our site?
Then try this link to forms for all 50 states and D. of Columbia.
experimentalvaccines.org/vaccine-exemption-forms/


Page Navigation Links

DayCare - Preschool - Schools - Colleges
California State specific information
DayCare-Preschool-K-12-Colleges
DayCare  |   Preschool  |   K thru 12  |   Colleges

The Medical Exemption is the only one available in California for new exemptions.

Commonly used links to:
Daycare Vaccination Requirements, K-12 Immunization Requirements, College Immunization Requirements, DOH link, Recent Law Changes and Tracking Registry Opt-out info. Here.

DayCare
CALIFORNIA PRE-KINDERGARTEN AND SCHOOL IMMUNIZATION RECORD
CDPH-286.pdf


https://www.pdffiller.com/6574266-fillable-pm-286-immunization-form-fillable

Commonly used links to:
Daycare Vaccination Requirements, K-12 Immunization Requirements, College Immunization Requirements, DOH link, Recent Law Changes and Tracking Registry Opt-out info. Summary Here.

Waiver of health examination. Page 1 is English, Page 2 is Spanish.
(.pdf) http://www.dhcs.ca.gov/formsandpubs/forms/Forms/ChildMedSvcForms/pm171b(bi).pdf.

The Medical Exemption is the only one available in California for new exemptions. Information: Calif Code snips


Preschool
See Daycare above.

Kindergarten & Schools
Commonly used links to:
Daycare Vaccination Requirements, K-12 Immunization Requirements, College Immunization Requirements, DOH link, Recent Law Changes and Tracking Registry Opt-out info. Summary Here.


SB277 does not prohibit a student who qualifies for an individualized education program (“IEP”) from accessing special education and related services required by his or her IEP.



Important:
July 1, 2011 a new Tdap booster vaccine is required to enter California schools, grades 7-12.



(For TB exemptions, you may use the CA state form PM 286 B below:)
and/or modify one of the letters below in the TB section)
Now requires user and password to obtain via this link
(.pdf)
CALIFORNIA PRE-KINDERGARTEN AND SCHOOL IMMUNIZATION RECORD
CDPH-286.pdf


Commonly used links to:
Daycare Vaccination Requirements, K-12 Immunization Requirements, College Immunization Requirements, DOH link, Recent Law Changes and Tracking Registry Opt-out info. Summary Here.

Waiver of health examination. Page 1 is English, Page 2 is Spanish.
(.pdf) http://www.dhcs.ca.gov/formsandpubs/forms/Forms/ChildMedSvcForms/pm171b(bi).pdf.


Colleges/Universities
California Immunization Handbook - EZIZ & School Vaccination Requirements K-12:
http://eziz.org/assets/docs/shotsforschool/IMM-365.pdf


Higher Ed Exemption Info:
California does not have a state exemption form for college students. Ask the college for an exemption form. [A few links to college forms are below.] If they do not have one write a letter or affidavit stating the vaccine is against your beliefs. See page D-76 of
http://eziz.org/assets/docs/shotsforschool/IMM-365.pdf
[The link at the top of this paragraph]

ONLINE FORMS:

CA State Fullerton University Hep B and MMR vaccine waiver form
(.pdf) http://www.fullerton.edu/studentwellness/pdfs/immunization_waiver_form.pdf

AFFIDAVIT for California Adult (college religious exemption) ... Edit as needed...
You may use this for employment situtations as well.

Note: In California, vaccine exemptions come under the broad term, "Personal Beliefs Exemption" (PBE) and thus a wide range of beliefs are protected. Our affidavits may be modified to reflect beliefs other than what we provide as an example.
California Older Child HTML SAMPLE Affidavit   |   Information: Calif Code snips


Affidavit Index

An Adult Affidavit, with Christian beliefs, is Downloadable here. (MSDOC file) Feel free to modify as needed.

Index of Letters/Affidavit files.


California State specific information for various Opt-Outs
Vaccine Registry Opt-Outs:

Immunization Tracking System opt out [eliminated]
Patient and Parent Rights
http://cairweb.org/images/docs/SIISDisclosureform_MedicalOfficeHandout_REV62111.pdf

It's your legal right to ask: Blocking other CAIR providers
See this web page: CAIR-records-forms

OptOutRegistry for Vaccines
and various other Opt-Outs



Vaccine Registry Opt-Outs:

KNOW YOUR RIGHTS
Confidentiality of Your Child’s Vaccination Records
FERPA: The Family Educational Rights and Privacy Act
vaxchoicevt.com

     - - - - Other Opt-Outs - - - -:

Birth Certificate and Marriage License Opt-Out:

Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so?
See: Marriage Licenses, Birth Certificates & #SSNs

Military Recruiters:
Opt-Out For Children in public schools to to have information withheld from military recruiters.
https://nnomy.org/en/resources/counter-recruitment/opt-out-student-lists.html


STUDENT OPT OUT FORM regarding the
RELEASE OF NAME, ADDRESS, AND TELEPHONE NUMBER TO MILITARY RECRUITERS
pdf file (.pdf) Archived letter from militaryfreeschools.org

UNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM
Word-Document (.doc) Archived on VacLib.org: veterans4peace.org/opt_out.doc

SAMPLE ENGLISH - BILINGUAL FORMS FOR OPTING OUT
Act to Protect Your Privacy from Military Recruiters
Information links and booklets at AFSC site

STUDENT OPT-OUT NOTICE regarding the instruction of sexuality to children:
STUDENT OPT-OUT NOTICE Valid in all 50 states
PDF-file (.pdf) armenianchurchlibrary.com/files/national_opt-out.pdf

STUDENT OPT-OUT NOTICE - Google Search



California State specific information Employment

Note: Hospital Health Care Workers in California may opt out of yearly influenza shots.
California Health Care Workers
Source: https://www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/HealthcarePersonnelInfluenzaVaccinationReportingInCA_Hospitals.aspx

California Hospital Influenza Law

With the chaptering of SB 739, the California Health and Safety Code will read effective January 1, 2007.

1288.7. By July 1, 2007, the department shall require that each general acute care hospital, in accordance with the Centers for Disease Control guidelines, take all of the following actions:
(a) Annually offer onsite influenza vaccinations, if available, to all hospital employees at no cost to the employee. Each general acute care hospital shall require its employees to be vaccinated, or if the employee elects not to be vaccinated, to declare in writing that he or she has declined the vaccination.
(b) Institute respiratory hygiene and cough etiquette protocols, develop and implement procedures for the isolation of patients with influenza, and adopt a seasonal influenza plan.
(c) Revise an existing or develop a new disaster plan that includes a pandemic influenza component. The plan shall also document any actual or recommended collaboration with local, regional, and state public health agencies or officials in the event of an influenza pandemic.

For the text of the entire bill, see http://www.leginfo.ca.gov/pub/05-06/bill/sen/sb_0701-0750/sb_739_bill_20060928_chaptered.html

Download: (.doc) California Adult Vaccine Exemption

California Exemption letter written by Adventist Church Council member.
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
HEPATITIS B VACCINE DECLINATION FORM (University Employees) OSHA
OLD/Archived
(.pdf) 1st Web Archive Link
(.pdf) 2nd Web Archive Link
(.pdf) 3rd Web Archive Link
(.pdf) 4th Web Archive Link

Stanford University - Stanford, California
Hepatitis B Vaccine Declination Form (University Employees)
(.pdf) https://ehs.stanford.edu/wp-content/uploads/Hep_B_Vaccine_Declaration_Form.pdf

TB Test: Yes; mandated.

However, exemption is allowed
CHAPTER 2. Tuberculosis Tests for Pupils [121475 - 121520]
121475.
(c) Exemptions from tuberculosis tests because of personal beliefs.
https://leginfo.legislature.ca.gov/...



University of California, Berkeley - Graduate School of Education - TB Skin Test required.

TB Testing Exemption Letter:


General Employment

Suggestions for dealing with Employer Mandates.



OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
See TB Testing for more information.

US Fish and Wildlife Service Form 3-2283
Hepatitis B Immunization Consent/Refusal Form
PDF-file (.pdf) ARCHIVED: http://www.fws.gov/forms/3-2283.pdf


Page Navigation Links


California State specific information TB Testing
CHAPTER 2. Tuberculosis Tests for Pupils [121475 - 121520]
121475.
(c) Exemptions from tuberculosis tests because of personal beliefs.
https://leginfo.legislature.ca.gov/...


TB-Links/Exemptions

California Specific w/California Health and Safety Code 121475 (b)
HTML [California]
Sample Letter for exemption to TB testing - California TBCalif.htm
MS DOC
Sample Letter for exemption to TB testing - California TBCalif.doc
WordPerfect
Sample Letter for exemption to TB testing - California TBCalif.wpd
PDF
Sample Letter for exemption to TB testing - California TBCalif.pdf

Generic letter for Exemption to TB Testing:
HTML (text): Exemption-tb-test.html

MS Doc file: Exemption-tb-test.doc

OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."

School Employees: (TB test)
Regarding legal requirement, Optional tests and X-ray final determination.
http://law.justia.com/codes/california/2009/hsc/121525-121555.html


The CDC approves, the skin test, and TB blood tests.

Religious Exemption for School Employees: (TB test)
EDUCATION CODE SECTION 49400-49415

49406.
    (g) If the governing board of a school district determines by resolution, after hearing, that the health of pupils in the district would not be jeopardized thereby, this section shall not apply to any employee of the district who files an affidavit stating that he or she adheres to the faith or teachings of any well-recognized religious sect, denomination, or organization and in accordance with its creed, tenets, or principles depends for healing upon prayer in the practice of religion and that to the best of his or her knowledge and belief he or she is free from active tuberculosis. If at any time there should be probable cause to believe that the affiant is afflicted with active tuberculosis, he or she may be excluded from service until the governing board of the employing district is satisfied that he or she is not so afflicted.


Exemption to TB tests for Students
Division 105, Communicable Disease Prevention and Control
Part 5, Tuberculosis
Chapter 2, Tuberculosis Tests for Pupils

HS §121475
Legislative intent
(c) Exemptions from tuberculosis tests because of personal beliefs.
Laws Related to Tuberculosis Prevention and Control in California
https://www.cdph.ca.gov/...


General Information: TB and/or Lead Testing



OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
Generic letter for Exemption to TB Testing:
HTML (text): Exemption-tb-test.html

MS Doc file: Exemption-tb-test.doc

TB and Lead Testing Links:
F L Y E R    LETTER    Exemption_Letters    OSHA_and_TB_test    Tubersol    Treatment    TB_Screening    Alternatives/Additional_Information

The above TB and Lead exemption letters are courtesy of Deirdre DeVane of Wash DC. Thank you Deirdre!
The adult TB letters were edited by Sherri Tenpenny. Thank you Sherri!

TB can be detected by biofeedback machines that are hooked up to a computer, such as the QXCI, Best BioMeridian MSAS (Meridian Stress Assessment) or Electro Dermal Screening, Quantum Life System, and the F-Scan. You will need to ask specifically for a pathogen scan, especially TB. You will also need to request a printout with the results.

Next (below) in Misc are some QXCI and other practitioners. (If known.)



Misc Info and explanation of QXCI - Etc.

QXCI SCIO EPFX Overview



(The SCIO and the EPFX are the same device.
It is known as the EPFX in the USA and the SCIO world wide.)
Source:
energymedicinereview.com/qxci-scio-epfx.html [Now inactive]

National (USA) search on business site for EPFX (QXCI) / SCIO Practitioners.
alternativesforhealing


Use Google or other search engine to find a BioMeridian Practitioner in your area.

If you do not find a practitioner, you can contact the current device manufacturer for the practitioner in your area.
ihtbio.com/support-and-help/


Australia State specific information Misc/QXCI

QXCI providers in California
California BEST™ BioMeridian Practitioners:

Jace Wellness Center
Craig Jace, DOM, L.Ac., PA-C, ND
10843 Mangolia Blvd, Ste 1
No. Hollywood, CA 91601
Phone: (818) 505-8610
http://www.jacemedical.com
E-mail: drj@jacemedical.com

American Herbal Laboratories, Inc.
Dr. Luke Cua, P.H.D., O.M.D., L.A.C.
8526 E. Garvey Ave.
Rosemead, Ca 91770
Tel: (800) 307-0928, (626) 307-0928
Fax: (626) 307-9445
http://www.newvita.com/
Email: herbal@newvita.com

Dr. Glen Canale
P.O. Box 366
Idyllwild, CA. 92549
USA
P/F +1-909-659 5817
I use several machines in my practice including: EAV, Cymatic Therapy, Molecular Enhancement, Amythst Regenerator, Oxone Therapy, Ray Light Beam, F-Scan, Audio Visual Stimulation, Voice Analysis, QGM Machine, Color Therapy, Swing Master, Juice Therapy, Mini Thumper. I have been trained in Russia, Ukraine, England, and the U.S. My Doctorate is in Cymatic Therapy. I use the Clark Therapy with the use of the F- Scan machine.

California QXCI Practitioners:

http://www.hope4cancer.com
A clinic in Mexico (Playas de Tijuana, Mexico) which treats cancer and a variety of other aliments. Click on link for available modalities which include Oxygen, Chelation, Electronic Homeopathy, Micor-current Therapy, Rife, Color, etc. They use the QXCI equipment also.

Northern California
Ariana Gossfeld
Specializing in flower essences, emotional therapy, gemmotherapy (cellular drainage) and oligo therapy (trace mineral for increased enzymatic activity).
Boulder Creek, CA 95006
831-338-1982
arianaqx@earthlink.net
See more info below under Southern California



Southern California

Roopa Chari or Deepak Chari
4401 Manchester Ave
Suite 201
Encinitas, CA 92024
760-230-2711
https://www.charicenter.com/

Ariana Gossfeld, CBT, CMT
Certified Biofeedback Therapist, Certified Flower Essence Practitioner, Certified Massage Therapist, Certified Triom Biomagnetics Instructor, EPFX / QXCI Practitioner
Spiritual and Emotional Counseling, Gemmotheraphy and Oligotherapy Counsleing
Fees:
$125 initial EPFX / QXCI session
$75 follow up session
$45 Flower Essence Session
$100 Massage
South Bay Area, Santa Cruz Mountain Area, Santa Cruz, CA
28388 Big Basin way
Boulder Creek, CA 95006
831-338-1982
https://www.alifeexperience.net/about_me.htm

Marcy Jimenez, CBT
Certified Biofeedback Therapist, EPFX / QXCI Practitioner
Fees:
$150 First Visit
$100 Revisit
Tiujana, Mexico
San Diego, CA
Web Address: www.hope4cancer.com

Dr. HarHari Khalsa
1649 S Robertson Boulevard
Los Angeles, CA 90035
833-333-0425
https://www.transformationalhealinguniverse.com/

Michael Mohoric
Certified Qigong Teacher, EPFX / QXCI Practitioner
Stress Reduction, Pain reduction, Disease Prevention, Physical, Emotional, and Spiritual issues, Space Clearing
Fees:
$150 for the first, 2 hour session
$90 per hour for follow up sessions
Laguna Area, Orange County, North San Diego County, CA
PO Box 6548 Laguna Niguel, CA 92607
Info: About: https://www.qigongenergyhealing.com/
More: Contact: https://www.qigongenergyhealing.com/purchase-information




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