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Minnesota State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page |
Click for the desired information for your stateNew Born Issues: NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_AffidavitsSchool-Daycare-Preschool Issues: Schools | DayCare | Preschool | K-12 | College | (options) OptOutRegistry | Adult Issues: Employment | TB_and/or_LeadTesting Statues/Laws | Waivers_CareInSigning | Misc_Info, QXCI providers, Sponsors, etc. |
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Statues/Laws
Link to state law.National Vaccine Information Center: Link to state law. For additional help with exemptions, birth plan,etc questions: Non_Vaccinating_Physicians 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 & Philosophical |
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PDF documents (.pdf) A PDF reader is required for PDF Files: Free Foxit Reader 12 MB file size. Or Free Download of Acrobat Reader: [Adobe. 43 MB file size] |
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NewBorn Birthing Plan and Birth Exemptions
BirthExemptions |
Birthing_Plans |
Vitamin_K |
Hepatitis_B |
Eyedrops |
Newborn_ScreeningBirth 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:
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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: (.pdf) birthplan-itemized.pdf(HTML) BirthPlan-Itemized for reading on screen. Includes handy small dictionary of terms in the document. Model Birth Plan Letter for Hospital Births. This one is more detailed. 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)
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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 If your Title and Paragraph number of your state law is not pasted above, click here for the link to your state law. |
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Vitamin K Injection... 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. |
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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 |
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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 |
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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! 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 |
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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 |
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DayCare - Preschool - Schools - Colleges
DayCare-Preschool-K-12-CollegesDayCare | Preschool | K thru 12 | Colleges Home page of MDH for Minnesota's School Immunization Law Exemption Provision http://www.health.state.mn.us/divs/idepc/immunize/laws/exemption.html
DayCare Child Care Immunization Record (PDF: 198KB/2 pages) http://www.health.state.mn.us/divs/idepc/immunize/laws/childcareimzrec.pdf See schools below for link to free Notary.
Preschool See schools below for link to free Notary and forms. ECSE Immunization Record (PDF: 134KB/2 pages) Updated 5/10 Children in the Early Childhood Special Education (ECSE) program must have this completed form on file with the school. ECFE / School Readiness Immunization Record (PDF: 120KB/1 page) Updated 6/08 Children participating in Early Childhood Family Education (ECFE) programs need to submit this completed form before starting classes.
Kindergarten & Schools Free or Low-Cost Places to Get Your Conscientious Objection Form Notarized: http://www.health.state.mn.us/divs/idepc/immunize/laws/notary.html To do this, you may either... Use the MDH pupil health record form, now called "Pupil Immunization Record" (.pdf) English: http://www.health.state.mn.us/divs/idepc/immunize/pupilimzrec.pdf or Spanish: http://www.health.state.mn.us/divs/idepc/immunize/pupilimzrecspan.pdf, which has a place for a parent's/guardian's signature and the notary's stamp. Other MN immunization related forms can found here.
Colleges/Universities
Immunization Record for Students Attending Post-Secondary Schools in Minnesota (PDF: 42KB/1 page) Sample form for college students to record Td and MMR immunizations, or exemption(s). MN college statute 135A.14 Statement of immunization of postsecondary students.
An Adult Affidavit, with Christian beliefs, is here. (MSDOC file)
Feel free to modify as needed.
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OptOutRegistry for Vaccines
Vaccine Registry Opt-Outs:and various other Opt-Outs Members of the public may "opt out" of MIIC, by completing and returning the Opt Out form. If you have questions about this process, or the implications of removing yourself from this system, please contact Hennepin County Immunization Services at 612-348-2741. Click here for page on ImmuLink and MIIC in Minnesota 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) http://www.militaryfreeschools.org/PDF/optout2.pdfUNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM 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) http://www.catholiccitizens.org/content/img/f26422/opt%20out%20notice.pdfSTUDENT OPT-OUT NOTICE - Google Search |
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Employment
OSHAStandard 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)
http://www.fws.gov/forms/3-2283.pdf |
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TB and/or Lead Testing 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. Here are some of the practitioners for Minnesota Minnesota BEST BioMeridian Practitioners: Benessere Body in Balance Kay Troan 125 Main St. SE, Suite 237 Minneapolis, Minnesota 612-378-WELL (9355) / 1-888-499-WELL (9355) http://www.benesserebodyinbalance.com/ MSAS, Meridian Stress Assessment System. The MSAS is the latest technology available in meridian stress assessment. The MSAS' primary objectives are to disclose patterns of stress and to provide feedback for use in a program that helps restore each system and meridian to a natural balance. It is a completely non-invasive method for gaining valuable information about the body's vital functions. Please call contact below to find additional BioMeridian practitioners in your area or closeby. Oksana Gorodetsky Marketing/Administrative Coordinator BioMeridian International 12411 South 265 West, Suite F Draper, UT 84020 T 801-501-7517 F 801-501-7518 Toll Free 888-224-2337 ogorodetsky@biomeridian.com Minnesota QXCI Practitioners: http://www.theqxci.com/practitioners.php#central Main page of practitioners: http://www.theqxci.com/information.php Kathy Beehler Quantum Consultant General EPFX / QXCI Practitioner Bemidji, MN 56601 218-243-2958 For information on purchase or lease of the new Quantum Life BioFeedback L.I.F.E. System, please email Donna and leave your name, mailing address, phone number and email. If you're inquiring for another interested individual or practitioner, please leave their information. The company will then send information and contact the interested parties. Or you may call 1-407-672-6144. |
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Misc Info - QXCI providers - Sponsors - Etc.
Information on this page is provided and sponsored by: |