Vaccination Liberation Information
Main Page Links


Kansas State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page


Statutes/L A W S
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 page for help in your state.

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


- - - Available Exemptions - - -
Medical  &  Religious


"Submit a written statement signed by a parent that the parent is an adherent of a religious denomination whose teachings are opposed to immunizations"
Note: That can be challanged.
It is unconstitutional, as it restricts religious exemptions from vaccination solely and exclusively to "bona fide members of a recognized religious organization".
Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.

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.

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]

Related Pages


State Resource Individuals

Finding Non_Vaccinating_Physicians


Information below on the left with a yellow background is Specific to your state. Information below on the right with a light grey/blue background is general information.
Page_Navigation_Links
New Born
NewBorn Birthing Plan and Birth Exemptions
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.

Birth Plans (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.

"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.

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/2016/08/the-question-of-vitamin-k-for-newborns/

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
http://fdb.rxlist.com/drugs/drug-9003-Aqua-Mephyton+Inj.aspx?drugid=9003&drugname=Aqua-Mephyton+Inj
"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:
http://vaclib.org/chapter/inserts.htm#vitK

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

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:

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/dailymed/lookup.cfm?setid=e8808230-2c44-44c6-8cab-8f29b6b34051

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

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

Eyedrops
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

Kansas State specific information
The Kansas Department of Health and Environment
Newborn Screening Program
http://www.kdheks.gov/newborn_screening/

Newborn Screening Practitioner's Manual...(Out of date, Archived on archive.org)
http://web.archive.org/web/20120228175129/http://www.kdheks.gov/newborn_screening/practitioner_manual.htm

(.pdf) [ARCHIVED] Appendix_C_Religious_Objection_Example.pdf (Sample Only)
*However, we were able to make exact copies without sample only stamp.
Note: this form is no longer offered on Kansas State website. Below are Appendix C Religious Objection letters to download and use:
(.doc) ../letters/ReligiousObjectionForGeneticMetabolicScreening.doc

(.pdf) ../letters/ReligiousObjectionForGeneticMetabolicScreening.pdf

May I refuse these tests?
Most states have specific laws regarding newborn screening. In Kansas you may refuse for religious reasons. If you do so, you may be asked to sign a refusal form. This form relieves your doctor of liability for damages that result from a disorder that could have been detected by screening.
Example refusal form:

28-4-512. Parental education.
(a) Providers of prenatal health care shall discuss and distribute written material describing the newborn screening program as a component of the prenatal care to pregnant women.

(b) Prior to obtaining the specimen for newborn screening, the person responsible for obtaining the specimen shall inform the parent or parents about the newborn screening program, including how the test can be refused. Authorized by K.S.A. 65-101; implementing K.S.A. 65-182; effective, T-87-48, Dec. 19, 1986; effective May 1, 1987.

See letters above for sample refusal form

Newborn Screening Regulations in Kansas: [Kansas Administrative Regulations]
http://www.kssos.org/pubs/pubs_kar.aspx

Hearing Screening

Statute: Sec.1 (c) Informed consent of parents shall be obtained and if any parent or guardian of a child objects to the mandatory examination for detection of significant hearing loss the child is exempt from subsection (b) of this section.

[Source: House Bill No. 2362]
In accordance with Kansas Statute: Sec.1 (c) (I/we) certify that the hearing screening to my child, ________________________, is contrary (our/my) personal religious beliefs, held either individually or jointly with others, and (I/we) therefore request that my child be exempt from the hearing screening and examinations of Kansas Statute: Sec. 1 (b).


Signature: __________________________ Date: _____________

Signature: __________________________ Date: ______________

Vision Screening:
PARENT/GUARDIAN CONSENT/REFUSAL FOR SCREENING

A parent or guardian has the right to refuse screening on children under his/her legal custody. A written, signed statement from the parent/guardian indicating refusal is recommended for school screenings.

The Vision Screening Task Force recommends that school districts inform parents of the vision screening process prior to its occurrence in the school. This information can be provided through the school newsletter, local newspaper or other media, and/or a letter to each student’s family. Providing information about an upcoming school-screening program prior to its occurrence gives parents the opportunity to decide whether or not to allow the test to be performed on their children. A form denying permission for vision screening should be included with the letter of explanation of the procedure. If the form is not returned with the parent’s or guardian’s signature to the school by a designated time, stating the child should not be screened, the child will automatically be screened.

Written, signed parental consent is required for Infant-Toddler Part C screenings. [K.A.R. 28-4-551 (e)]

In the case of provision of EPSDT and well child clinics, vision screening is a portion of the required screening services; thus, the waiver of screening does not apply.
See Page 8 of the Vision Guidelines.
A parent or guardian has the right to refuse screening on children under his/her legal custody. A written, signed statement from the parent/guardian indicating refusal is recommended for school screenings.
(.pdf) www.kdheks.gov/bfh/download/VisionGuidelines2004.pdf


New Born Screening
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 - http://genes-r-us.uthscsa.edu/nbsdisorders.pdf

Newborn Genetic Screening Privacy Laws
(includes links to laws for various states)
Archived Copy: http://web.archive.org/web/20130603035608/http://www.ncsl.org/issues-research/health/newborn-genetic-and-metabolic-screening-laws.aspx

Newborn screening From Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/Newborn_screening

Federal NewBorn Screening Law (from Families of Spinal Muscular Atrophy)
http://www.fsma.org


Page_Navigation_Links
Waivers: Read - Modify or Do Not Sign
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/2014/03/04/
why-you-must-not-sign-a-refusal-to-vaccinate-form-at-least-if-you-want-to-keep-your-kids-that-is/


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 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 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.


Page_Navigation_Links
Letters Forms Affidavits
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 has the following forms on her web site. The forms are generic and may be used in any state.

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

http://drtenpenny.com/forms/

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

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.
http://experimentalvaccines.org/vaccine-exemption-forms/


Page_Navigation_Links
DayCare - Preschool - Schools - Colleges
DayCare - Preschool - Schools - Colleges
DayCare-Preschool-K-12-Colleges
DayCare  |   Preschool  |   K thru 12  |   Colleges

DayCare
Day Care Forms


2014 Kansas Statutes
Chapter 65 PUBLIC HEALTH
Article 5 MATERNITY CENTERS AND CHILD CARE FACILITIES
65-508 Equipment, supplies, accommodations; competent supervision and care of children; rules and regulations; immunizations.
(e) The immunization requirement of subsection (d) shall not apply if one of the following is obtained:

(1) Certification from a licensed physician stating that the physical condition of the child is such that immunization would endanger the child's life or health; or

(2) a written statement signed by a parent or guardian that the parent or guardian is an adherent of a religious denomination whose teachings are opposed to immunizations.

[Apparently, the parent must provide this statement. No state form was found.]

Note: see our comment regarding "adherent of a religious demonination".

Kansas requirements, religious exemption allowed:
Immunization information and KCI forms are available at schools, at most health care providers and at the Wichita-Sedgwick County Department of Community Health, 1900 E. 9th, Wichita, KS 67214, or call 268-8441.

Kansas Certificate of Immunization (KCI Form)
(.pdf) Immunization Form
http://www.kdheks.gov/immunize/download/KCI_Form.pdf

Kansas Certificate of Immunization (KCI Form) Form B Medical Exemption
(.pdf) http://www.kdheks.gov/immunize/imm_manual_pdf/KCI_formB.pdf


Preschool
See Daycare above.

Kindergarten & Schools
Religious Exemption: State Form Required? No. A religious objection may be made in writing, signed & delivered to teacher or individual who ordered immunizations.



Subj: Exemption from Immunization Form
Date: 9/10/2004 7:14:17 AM Pacific Daylight Time
From: MSiemsen @ kdhe.state.ks.us
To: Services4Health@...
CC: SWatson @ Kdhe.state.ks.us
Sent from the Internet (Details)

Your request for information regarding a school exemption from immunization form was referred to me.

Kansas law KSA 72-5209 (b) says as an alternative to the certification required (tests and/or inoculations) (1) An annual written statement signed by a licensed physician stating the physical condition of the child to be such that the test or inoculations would seriously endanger the life or health of the child, or (2) A written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.

At this time, Kansas state law provides for only medical or religious exemptions.

There is a medical exemption state form B that must be signed yearly by a physician, either an MD or DO. The religious exemption may be signed by the parent/legal guardian on the Kansas Certificate of Immunization (KCI)

You may download a KCI at the following address:
(.pdf) http://www.kdheks.gov/immunize/download/KCI_Form.pdf

The Medical Exemption Form B can be found at:
(.pdf) http://www.kdhe.state.ks.us/immunize/download/kci_form_b.pdf

If I can be of further assistance, please do not hesitate to contact me.



Great things are possible when people persevere

Martha Siemsen, RN, ARNP
Kansas Immunization Program Assistant Director
1000 SW Jackson, Suite 210
Topeka, KS 66612-1274
Phone 785-296-2774
Fax 785-296-6510
e-mail msiemsen @ kdhe.state.ks.us
www.kdhe.state.ks.us/immunize



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

Kansas Certificate of Immunization (KCI Form) Form B Medical Exemption
KCI-Form B http://www.kdheks.gov/immunize/imm_manual_pdf/KCI_formB.pdf (.pdf)

Note:   Regarding Kansas law KSA 72-5209 (b) (2)
(2) A written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.
Note: see our comment regarding "adherent of a religious demonination".


Colleges/Universities
HASKELL INDIAN NATIONS UNIVERSITY
CERTIFICATE OF IMMUNIZATION (12/04)
STATEMENT OF EXEMPTION TO IMMUNZATION at bottom of page...
http://www.haskell.edu/downloads/admission/HINU%20Immunization%20Form.pdf

THE UNIVERSITY OF KANSAS
MMR and WAIVER OF MENINGOCOCCAL MENINGITIS IMMUNIZATION bottom of page 2
(.pdf) http://www.studenthealth.ku.edu/sites/studenthealth.drupal.ku.edu/files/docs/ImmandHHF.pdf

Baker University
1500 Sw 10Th
Topeka, Kansas 66604-1353
Exemption is on page 2
(.pdf) http://www.bakeru.edu/images/pdf/BL_undergrad/healthform.pdf
Religious/Philosophical Exemption to Immunization Requirement
I ____________________________________________or

______________________________________________ object to the immunization of (circle) myself/the above named student to measles, rubella, mumps, diptheria/tetanus, polio. It is understood that exposure to these communicable diseases may cause disabilities and complications; and that in the event of a measles or rubella outbreak on campus, the above named student will be excluded from campus.
_____________________________________________
Signature of Student                         Date
(Parent/Guardian if student is under 18)
Kansas Wesleyan University
Salina, Kansas 67401-6196
(.pdf) http://www.kwu.edu/sites/default/files/Emergency Medical Form.pdf
Exemption on page 2.

Manhattan Christian College • Student Development Office • 2006-2007
Meningitis Record/Waiver
(.pdf) http://www.mccks.edu/sites/default/files/Meningitis%20Record%3AWaiver.pdf

http://www.mccks.edu/meningitis-recordwaiver (web page for registering a waiver)

Pittsburg State University
1701 S Broadway
Pittsburg, Kansas 66762
For Housing Students. Only Meningitis Waiver is needed to be filled out. Provided by Health Center of school.
Immunizations/TB Testing
Pittsburg State University does not require students to show proof of immunizations against certain communicable diseases. However, as a preventative measure, the American College Health Association (ACHA) has recommended that colleges offer students and parents an immunization guideline for your consideration.
http://www.pittstate.edu/office/health/immunizations-allergy-injections.dot

Friends University
2100 W. University St.
Wichita, Kansas 67213
Click here for Immunization Policy



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

Page_Navigation_Links
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
http://www.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:

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

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

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

STUDENT OPT-OUT - Google Search

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

STUDENT OPT-OUT NOTICE - Google Search

Employment
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) http://www.fws.gov/forms/3-2283.pdf


Page_Navigation_Links
TB and/or Lead Testing
State specific information
TB Test:

Required by McPherson College
Required by Emporia State University
Required by Bethel College
Required by Ottawa University
Required by Sterling College
Required by Kansas City Kansas Community College for health related fields.
Required by University of Kansas Medical Center

65-129e
Chapter 65.--PUBLIC HEALTH
Article 1.--SECRETARY OF HEALTH AND ENVIRONMENT, ACTIVITIES
      65-129e. Tuberculosis evaluation requirements for certain students; rules and regulations; evaluation criteria; treatment and monitoring of infected persons.

http://kslegislature.org/li_2012/b2011_12/statute/065_000_0000_chapter/065_001_0000_article/065_001_0029e_section/065_001_0029e_k/

The information below may be out of date. Confirm before making a decision.
SUBJECT:  Tuberculin Testing of Residents and Employees in Adult Care Homes Licensed as Nursing Facilities, Assisted Living Facilities and Residential Health Care Facilities.

K.A.R. 28-39-161 (b) (3)
K.A.R. 28-39-253 (b) (7)
K.A.R. 28-39-288 (b) (6)
K.A.R. 28-39-433 (b) (7)
42 C.F.R. 483.460 (a) (3) (10)
42 C.F.R. 483.470 (l) (4)

4.      If an employee refuses the skin tests, the employee must be examined by a physician for tuberculosis. This examination should include a chest x-ray. The results of this examination must be documented in the employee record. Additional x-rays are not required unless employee develops symptoms of tuberculosis.

5.      Residents who refuse the skin tests must be examined for tuberculosis by their physician and the results of this examination must be documented in the clinical record within 30 days of admission. A chest x-ray should be included in the examination. Additional x-rays are not required unless the resident develops symptoms of tuberculosis.
Pages 53 – 54

http://www.kdheks.gov/bhfr/download/Reg_Interp_02.pdf
TB-Links/Exemptions

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."
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.

See below in Misc some QXCI, etc practitioners.

Misc Info - QXCI - Etc.
General Information
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:
http://www.energymedicinereview.com/qxci-scio-epfx.html

National (USA) search results for EPFX (QXCI) / SCIO Practitioners.
http://www.alternativesforhealing.com/cgi_bin/practitioner-epfxqxciscio.php


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.
http://www.ihtbio.com/ihtblog/contact-support/

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