IDAHO - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)

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Exemption Letters & Forms...

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.

Vitamin K Injection...

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

"WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."
fatalities=death

Sample Vaccine Letters

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.

Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage:
(.pdf) http://www.nmaseminars.com/files/Hep_B_in_the_hospital_1_.pdf
This form is generic. It can be used in other states.

To refuse the birth dose of Hep B use Idaho Code §39-4804
I.C. §39-4804 is entitled "Notification to parent or guardian":

Before an immunization is administered to any child in this state, the parent or guardian of the child shall be notified that:

(1) Immunizations are not mandatory and may be refused on religious or other grounds;
(2) Participation in the immunization registry is voluntary;
(3) The parent or guardian is entitled to an accurate explanation of the complications known to follow such immunization.

The term OR OTHER GROUNDS means that you as an individual or parent have the right to choose whether or not to vaccinate your child. The statute does not require you to disclose what other grounds your refusal to immunization is. As with any medical decision, the decision to vaccinate or not is a right of the individual or parent. The State of Idaho, your doctor and public health employees cannot force you or your child to be vaccinated. Your child cannot be excluded from a school or public program because you have exercised your right to not vaccinate.

VACCINATION EXEMPTION PURSUANT TO IDAHO STATUTE I.C. §39-4804

"This is pursuant to my right to refuse Hepatitis B vaccination on the statutory grounds of "other grounds". Pursuant to the statute I am providing a copy of the statement to the hospital staff pursuant to I.C. §39-4804."
You may add this to one of the model birth plan letters below.

Or you may use this AFFIDAVIT below, edit it as you wish, and use along with page 45 of manual and model birth plan letter... (This fits nicely on 2 pages, front and back.)
AFFIDAVIT available in Microsoft Word (.doc) and WordPerfect (.wpd) format.

The above documents can also be made available in WordPerfect (.wpd) format.
Please contact us if you want the model birth plan letters in WordPerfect.

Sample Birth Plan from The Center of Unhindered Living

The birth plan arrangements and letter should be turned in before delievery date.

This "Refusal to Permit Medical Treatment" form is optional to use.
"Refusal to Permit Medical Treatment" form. A generic form.
(.pdf) http://www.scpie.com/riskmgmt/forms/refusal_treatment.pdf

It would be good idea to use with the AFFIDAVIT above AND model birth plan letter. We hope someone uses this affidavit, model birth plan letter and refusal forms, and succeeds. We want to hear about it when someone is successful with this. 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!

Birth plan religious AFFIDAVIT text above. Use with model birth plan letter and/or refusal forms, and edit as needed...
YOU WILL have to put your foot down and fight for your baby's rights.

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

Postnatal - 2 months (first "well baby" visit):

If you do take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware and careful of any forms you sign.

We're referring to those "Refusal To Vaccinate" forms put out by the American Academy of Pediatrics. Go to this page below and find out why signing this form is very dangerous. We all know about these forms and how they can be used to undermine parental rights...
http://www.vaclib.org/legal/donotsign.htm

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"By endorsing this particular waiver, parents would essentially be signing an admittance of neglect and or "abuse" for refusing vaccines. The language contained in this waiver could put parents and caregivers in jeopardy down-the-line if they should ever find themselves in the courts due to their child's health problems, when confronted with child protective services, divorce, or just about any matter pertaining to that child that could be used against the parent(s).

Please read any waiver provided by your child's doctor carefully before signing. Instead, offer a formally written and signed letter that simply says that you do not wish to vaccinate your child. If you are unsure of the language in the waiver, buy some time by telling your doctor that you need to consult with a lawyer before signing it. "

Anai Rhoads Ford
Human Rights Journalist
Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse by Anai Rhoads Ford, released 15 November 2005.
http://www.anairhoads.org/

Media Contact (703) 491-1903

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WARNING!

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: https://iris.idhw.state.id.us/irisweb/pdf/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.

NEW Child Care Exemption Form (See WARNING above)
State of Idaho
CERTIFICATE OF EXEMPTION
Child Care Immunization Requirement
(.pdf) https://iris.idaho.gov/irisweb/pdf/ChildCareExemptForm.pdf
This form is intended to be one page (front & back) printed on PURPLE paper.

State of Idaho
CERTIFICATE OF EXEMPTION (See WARNING above)
Immunization Provider
(.pdf) https://iris.idaho.gov/irisweb/pdf/Provider%20Exemption%20Form.pdf
*Please note that these forms are worded that a child is at risk of death, by not being vaccinated.   It is deliberate trickery in the wording, and one must be careful when using these forms.   They can be legally used against you later on.
It would be a good idea to skip initialing those statements and attach our Vac Lib exemption form which cites I.C. § 39-4804.

See Anai Rhoads article above and go to this page...
http://www.vaclib.org/legal/donotsign.htm

Here are examples of deliberate trickery in the wording of this State of Idaho forms:

Be sure to cross out ALL the nots, if you are asked to use these forms.

Page 1 of the form...

Please read the following statements and initial each statement regarding vaccine preventable diseases for which an exemption is being claimed.

Diphtheria: I understand by not receiving the Diphtheria vaccine, my child is at risk of developing a sore throat, low-grade fever, heart complications, paralysis, respiratory complications, coma and even death.
__________       _______________
Initial                   Date

Tetanus: I understand by not receiving the Tetanus vaccine, my child is at risk of developing seizures and possible fatal neuromuscular disease.
__________       _______________
Initial                   Date

Pertussis (Whooping Cough): I understand by not receiving the Pertussis vaccine, my child is at risk of developing pneumonia, seizures, inflammation of the brain, neurological complications and even death.
__________       _______________
Initial                   Date

Polio: I understand by not receiving the Polio vaccine, my child is at risk of developing a fever, sore throat, nausea, headaches, stomachaches, stiffness, and paralysis that can lead to permanent disability and death.
__________       _______________
Initial                   Date

Measles: I understand by not receiving the Measles vaccine, my child is at risk of developing a rash, high fever, cough, runny nose, red, watery eyes, diarrhea, ear infections, pneumonia, encephalitis, seizures, and death.
__________       _______________
Initial                   Date

Mumps: I understand by not receiving the Mumps vaccine, my child is at risk of developing a fever, headache, muscle aches, swelling of the lymph nodes close to the jaw, meningitis, inflammation of the testicles or ovaries, sterility, arthritis, inflammation of the pancreas and deafness (usually permanent).
__________       _______________
Initial                   Date

Rubella (German Measles) I understand by not receiving the Rubella vaccine, my child is at risk of developing a rash and fever in children and young adults, birth defects if acquired while pregnant include deafness, cataracts, heart defects, mental retardation, and liver and spleen damage.
__________       _______________
Initial                   Date

Hepatitis B: I understand by not receiving the Hepatitis B vaccine, my child is at risk of developing yellow skin or eyes, tiredness, stomachaches, loss of appetite, nausea, or joint pain, life-long liver problems, such as scarring of the liver and liver cancer.
__________       _______________
Initial                   Date

More deliberate trickery of the wording on Page 2

"I know that failure to follow the recommendations about vaccination may endanger the health or life of my child and others that my child might come in contact with. I acknowledge that I have read this document in its entirety and fully understand it."

You could alter the form and say:
"I know that failure to follow(ing) the recommendations about vaccination may endanger the health or life of my child and others that my child might come in contact with. I acknowledge that I have read this document in its entirety and fully understand it."

"RELIGIOUS or PERSONAL STATEMENT: I have investigated the risks of not vaccinating my child; nevertheless (therefore) I have decided to not vaccinate my child for the following reason(s):"
You may attach one of our Vaccination Liberation Idaho Exemption Forms, or simply cite I.C. § 39-4804

Schools:

Idaho - .doc file (MS 97/2000/XP)
(.doc)

NEW School Exemption Form (English) (See WARNING above)
State of Idaho
CERTIFICATE OF EXEMPTION
School Immunization Requirement
(.pdf) https://iris.idaho.gov/irisweb/pdf/SchoolExemptForm.pdf
(.pdf) State of Idaho CERTIFICATE OF EXEMPTION School Immunization Requirement
This form is intended to be one page (front & back) printed on PINK paper.

NEW School Exemption Form (Spanish) (See WARNING above)
Estado de Idaho
CERTIFICADO DE EXENCIÓN
Requisito de Inmunización Escolar
(.pdf) Estado de Idaho CERTIFICADO DE EXENCIÓN Requisito de Inmunización Escolar
This form is intended to be one page (front & back) printed on PINK paper.

State of Idaho
CERTIFICATE OF EXEMPTION (See WARNING above)
Immunization Provider
(.pdf) https://iris.idaho.gov/irisweb/pdf/Provider%20Exemption%20Form.pdf
*Please note that these forms are worded that a child is at risk of death, by not being vaccinated.   It is deliberate trickery in the wording, and one must be careful when using these forms.   They can be legally used against you later on.
It would be a good idea to skip initialing those statements and attach our Vac Lib exemption form which cites I.C. § 39-4804.

Here are examples of deliberate trickery in the wording of this State of Idaho forms:

Be sure to cross out ALL the nots if you are asked to use these forms.

Page 1 of the form...

Please read the following statements and initial each statement regarding vaccine preventable diseases for which an exemption is being claimed.

Diphtheria: I understand by not receiving the Diphtheria vaccine, my child is at risk of developing a sore throat, low-grade fever, heart complications, paralysis, respiratory complications, coma and even death.
__________       _______________
Initial                   Date

Tetanus: I understand by not receiving the Tetanus vaccine, my child is at risk of developing seizures and possible fatal neuromuscular disease.
__________       _______________
Initial                   Date

Pertussis (Whooping Cough): I understand by not receiving the Pertussis vaccine, my child is at risk of developing pneumonia, seizures, inflammation of the brain, neurological complications and even death.
__________       _______________
Initial                   Date

Polio: I understand by not receiving the Polio vaccine, my child is at risk of developing a fever, sore throat, nausea, headaches, stomachaches, stiffness, and paralysis that can lead to permanent disability and death.
__________       _______________
Initial                   Date

Measles: I understand by not receiving the Measles vaccine, my child is at risk of developing a rash, high fever, cough, runny nose, red, watery eyes, diarrhea, ear infections, pneumonia, encephalitis, seizures, and death.
__________       _______________
Initial                   Date

Mumps: I understand by not receiving the Mumps vaccine, my child is at risk of developing a fever, headache, muscle aches, swelling of the lymph nodes close to the jaw, meningitis, inflammation of the testicles or ovaries, sterility, arthritis, inflammation of the pancreas and deafness (usually permanent).
__________       _______________
Initial                   Date

Rubella (German Measles) I understand by not receiving the Rubella vaccine, my child is at risk of developing a rash and fever in children and young adults, birth defects if acquired while pregnant include deafness, cataracts, heart defects, mental retardation, and liver and spleen damage.
__________       _______________
Initial                   Date

Hepatitis B: I understand by not receiving the Hepatitis B vaccine, my child is at risk of developing yellow skin or eyes, tiredness, stomachaches, loss of appetite, nausea, or joint pain, life-long liver problems, such as scarring of the liver and liver cancer.
__________       _______________
Initial                   Date

More deliberate trickery of the wording on Page 2

"I know that failure to follow the recommendations about vaccination may endanger the health or life of my child and others that my child might come in contact with. I acknowledge that I have read this document in its entirety and fully understand it."

You could alter the form and say:
"I know that failure to follow(ing) the recommendations about vaccination may endanger the health or life of my child and others that my child might come in contact with. I acknowledge that I have read this document in its entirety and fully understand it."

"RELIGIOUS or PERSONAL STATEMENT: I have investigated the risks of not vaccinating my child; nevertheless (therefore) I have decided to not vaccinate my child for the following reason(s):"
You may attach one of our Vaccination Liberation Idaho Exemption Forms, or simply cite I.C. § 39-4804