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

PDF documents (.pdf)

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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

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

It would be good idea to use with the AFFIDAVIT below AND model birth plan letter. I 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 below. Use with model birth plan letter and/or refusal forms, and edit as needed...
AFFIDAVIT available in Microsoft Word (.doc) and WordPerfect (.wpd) format.

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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. "

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Use same as schools below.

Religious Exemption from Lead Screening allowed.
MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE BLOOD LEAD TESTING CERTIFICATE (.pdf) DHMH4620

RELIGIOUS OBJECTION:
1. I am the parent/guardian of the child identified above. Because of my bona fide religious beliefs and practices, I object to any blood lead testing of my child.
Signed _________________________ / ________
Parent or Guardian Date

Schools:

Description : Maryland DHMH 896
(Sign & date religious objection at bottom of page 1 or get medical doctor to sign medical contradiction)

(.pdf) http://www.ymcamd.org/A-Resources/Branch_Resources/BranchDocuments/DHMH896.pdf

(.pdf) http://www.4ccn.org/immunizationcert.pdf

(.pdf) http://olphschool.org/DHMH896.pdf

AFFIDAVIT for Maryland Older Child below...
Can be used for daycare, preschools and schools, edit as needed.

Colleges & Universities:

Towson University Immunization Policy - Dowell Health Center - Towson University

VI. Exemptions from Immunization Requirements
Medical exemptions are vaccine-specific and require verification by a healthcare provider of the medical contraindication to a specific vaccine(s).

Religious exemptions require completion of a Request for Exemption on the basis of religious beliefs. Form is available at the Dowell Health Center and must be notarized.
Use the AFFIDAVIT for Maryland Adult (college religious exemption) and edit as needed.
_____________________________________

John Hopkins University - Maryland

Exemptions: A signed statement from a health care provider or clergy is required for exemption due to medical contraindications or religious belief.

Use the AFFIDAVIT for Maryland Adult (college religious exemption) and edit as needed.

*One can exercise their rights to receive religious exemption without clergy or belonging to a specific religious organization. See below:

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.
_____________________________________

Bowie State University
Henry Wise Wellness Center
Meningitis Vaccine Waiver    (.pdf)

TB Testing Exemption Letter:
HTML
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.htm
Microsoft Word Document (.doc)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.doc

TB Testing Exemption Letter for Adults:
Microsoft Word Document (.doc)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBTestingWaiverAdult.doc
WordPerfect Document (.wpd)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBTestingWaiverAdult.wpd
PDF document (.pdf)
Sample Exemption Letter for TB testing. http://www.vaclib.org/letters/TBTestingWaiverAdult.pdf
Extra link from Dr. Sheri Tenpenny's webpage:
(.pdf) http://www.nmaseminars.com/files/Exemption_for_TB_testing_1_.pdf

Lead Testing Exemption Letter:
HTML
Sample Exemption Letter for Lead testing. May be modified to your use. http://www.vaclib.org/letters/Lead_testing_waiverGen.htm
Microsoft Word Document (.doc)
Sample Exemption Letter for Lead testing. May be modified to your use. http://www.vaclib.org/letters/Lead_testing_waiverGen.doc

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

ImmuNet Maryland's Immunization Registry Data Sharing Refusal Form
(.pdf) http://www.cha.state.md.us/edcp/imm_new/pdf/data_sharing_refusal.pdf
This does not exempt for vaccinations. A separate exemption must be submitted to be exempt from vaccines.