NEW HAMPSHIRE - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)New Hampshire Current Statutes & Laws: http://www.909shot.com/state-site/NewHampshire.htm Medical & Religious If a parent objects to immunization because of religious beliefs, the parent or legal guardian shall sign a notarized form stating that the child has not been immunized because of religious beliefs.
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Gerhard Bedding Director, NH Citizens for Health Freedom 603-355-2202 Gerhard<gbedding@verizon.net> New Hampshire Libertarians Against Compulsory Vaccinations Sign The Petition here and make your voice heard in New Hampshire for a philosophical objection to vaccinations. http://www.geocities.com/rnroy03570/petition.htm 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) http://www.fda.gov/medwatch/SAFETY/2003/03Feb_PI/AquaMEPHYTON_PI.pdf"WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."The package insert should be printed out and used along with the birth plan letter, and your exemption letter or AFFIDAVIT. This shows the hospital or birthing center that you are aware of the risks of Vitamin K injection, and that they should be too. 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 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. 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. (Links to model birth plan letter and acceptance of responsibility) Acceptance of Responsibility. http://www.vaclib.org/legal/accept1.htm Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage: (.pdf) http://www.nmaseminars.com/files/Hep_B_in_the_hospital_1_.pdfThis form is generic. It can be used in other states. 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...  (.doc) Model Letter for Hospital Births (Model11425.doc) Model Birth Plan Letter for Hospital Births. This one is more detailed. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc... (.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) (.doc) VaccineTruth.net/letters/Model letter for hospital births for adoptions.doc
The above documents can also be made available in WordPerfect
Sample Birth Plan from The Center of Unhindered Living AFFIDAVIT I/We, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being(s), state Citizen(s) of the New Hampshire Republic affirm: Be it known to all courts, governments, and other parties that: Being (a person/people) of Strong Christian Morals, it is against (my/our) Deep, Sincerely Held, Religious Convictions to accept the injection of any foreign substance into (my Body/our Bodies) or the Body of (my/our) Child. This includes, but is not limited to, any and all, Vaccinations, Shots, Tests for Diseases, Oral Vaccines, Epidermal Patches and in any other way that Live or Killed Bacterium, Viruses, Pathogens, Germs, or any other Microorganisms, may be introduced into or upon (my/our) newborn's body. This written statement to exempt (my/our) newborn from any immunizations, newborn screening, and the Vitamin K shot, because (Iwe) hold genuine and sincere personal religious beliefs which are inconsistent with these medical procedures & experimentation. The practice of vaccination and the injection or application of any foreign substance is contrary to (my/our) conscientiously held religious beliefs and practices, and violates the free exercise of (my/our) religious principles. The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps (my/our) parental authority to condemn such activity in (my/our) child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of (my/our) faith. The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert. http://www.fda.gov/medwatch/SAFETY/2003/03Feb_PI/AquaMEPHYTON_PI.pdf "WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."A conflict arises because (my/our) religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of injection of carcinogenic substances that can kill. (We / I) {First and Last name(s)}, as the {(parent (s) / guardian(s)} of ______________________(name of newborn child) are exercising (our/my) rights under the First Amendment of the US Constitution and [insert New Hampshire immunization/testing exemptions birth statutes here] to receive Religious Exemption from Vaccination, ALL injections, & testing. 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. The Lord Jesus Christ and Our Creator are the only source of protection of (my body/our bodies) and that of (my/our) family that (I/we) can accept. (I/We) affirm that vaccination & injections of any foreign substances and proteins conflict with (my/our) religious beliefs as stated above. Therefore, (I/we) would request that you accommodate (my/our) religious beliefs and practices by exempting (my/our) newborn child from any vaccinations, injections and testing of any kind. Rest assured that (my family and I/our family) do practice a form of immunization that keeps our immune systems strong and is in keeping with Biblical principles. Further Affiant Saith Not The use of notary below is for identification only, and such use does NOT grant any jurisdiction to anyone. Subscribed and sworn, without prejudice, and with all rights reserved, (Print Name Below) _______________________________________________________________, Principal, by Special Appearance, in Propria Persona, proceeding Sui Juris. _______________________________ Signature of Affiant ACKNOWLEDGMENT state of New Hampshire county of _________________: On this _______ day of ______________, 200___, before me personally appeared __________________________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged that he executed the same as his free act and deed, for the purposes therein set forth. _______________________________________ (Notary Public) My Commission Expires ______________________________, 200___ Above AFFIDAVIT now available in both Microsoft Word  (.doc) and WordPerfect  (.wpd) format.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 Generic Vaccine Refusal Form from Dr. Sherri Tenpenny's webpage. (.pdf) http://www.nmaseminars.com/files/Vaccine_Refusal_Form.pdfState Form Required: No. The New Hampshire Exemption Form is available for both daycare/preschools and schools. Daycare & Preschools: CERTIFICATE OF RELIGIOUS EXEMPTION IN A CHILD CARE PROGRAM (IMMUNIZATIONS) 2004 Form. Must be notarized. The following Child Care forms are from this page: http://www.dhhs.state.nh.us/DHHS/BCCL/LIBRARY/Form/cc-licensing-package.htm (.pdf) Certificate of Religious Exemption-Immunizations (1 page)
New Hampshire Certificate of Religious Exemption in a Child Care Program (Physical Examinations) (PDF File) (.pdf) NH Certificate of Religious Exemption in a Child Care Program (Physical Examinations)This too must be notarized. New Hampshire Certificate of Religious Exemption in a Child Care Program (Immunizations). It can also be used for school children. Also download the letter to turn in along with it (see below). The bureaucrats may try to refuse the exemption form, but the letter from the department says it's used for other than child care program. (.pdf) NH_religious.pdf (exemption form immunization) Old form hosted on vaclib.org. NEW!! Now there is a separate school form available. See under schools below, the 2005 Certificate of Religious Exemption. TITLE X. PUBLIC HEALTH CHAPTER 141-C. COMMUNICABLE DISEASE RSA 141-C:20-a (2002) § 141-C:20-a. Immunization I. All parents or legal guardians shall have their children who are residing in this state immunized against certain diseases. These diseases shall include, but not be limited to, diphtheria, mumps, pertussis, poliomyelitis, rubella, rubeola, and tetanus. The commissioner shall adopt rules under RSA 541-A relative to other diseases which require immunization. II. No child shall be admitted or enrolled in any school or child care agency, public or private, unless the following is demonstrated: (a) Immunization under paragraph I; (b) Partial immunization relative to the age of the child as specified in rules adopted by the commissioner; or (c) Exemption under RSA 141-C:20-c. RSA 141-C:20-c (2002) § 141-C:20-c. Exemptions A child shall be exempt from immunization if: I. A physician licensed under RSA 329, or a physician exempted under RSA 329:21, III, certifies that immunization against a particular disease may be detrimental to the child's health. The exemption shall exist only for the length of time, in the opinion of the physician, such immunization would be detrimental to the child. An exemption from immunization for one disease shall not affect other required immunizations. II. A parent or legal guardian objects to immunization because of religious beliefs. The parent or legal guardian shall sign a notarized form stating that the child has not been immunized because of religious beliefs. Schools: NOW AVAILABLE!! Elementary School Form!! - Grades K - 12 State of NH Certificate of Religious Exemption form ... To be granted Religious Exceptions the following form is required to be completed and submitted to the appropriate school administrators or school health officials. (.pdf) CERTIFICATE OF RELIGIOUS EXEMPTIONMust be notarized. Accompanying Letter to go with NH child care exemption form. Use exemption form above. (This letter must be used with the exemption for school since exemption says child care. This will ensure that the exemption is granted for public schools.) (.doc)
VaccineTruth.net/letters/NHWebmailCertRelExemp(5189).doc
Now there is a 2005 School Form (Grades K-12), separate from the Child Care Religious Exemption Form! See Above. Summer Camp: Interlocken at Windsor Mountain Summer Camp Use the new exemption form from New Hampshire. (.pdf) CERTIFICATE OF RELIGIOUS EXEMPTION
Colleges & Universities: Good religious reasons... These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here, attach rationale, or state why a particular vaccination is contrary to your religious beliefs, etc... Often you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities. Q: What constitutes a religious conflict with vaccination? A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials. A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities. Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue. A conflict arises if your religious convictions are predicated on the belief that all life is sacred. God’s commandment “Thou Shall Not Kill” applies to the practice of abortion. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from. The Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of abortion. The acceptance of this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill". The Chickenpox (Varivax) vaccine containing MRC-5 and RA 273, is obtained from human babies that were electively aborted. The acceptance of this vaccine promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill". The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith. For a child under age 18, where parent has to make the statement, concerning Hep B vaccine... The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps my parental authority to condemn such activity in my child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith. ”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994] “The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994] (Indicate rationale and attach statement from clergy or other authority.) You do not need to belong to a church or religious organization to claim religious exemption from vaccines. 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. AFFIDAVIT for New Hampshire Adult (college religious exemption) ... Edit as needed... AFFIDAVIT is available in Microsoft Word (.doc) and WordPerfect (.wpd) format.
Contact us.AFFIDAVIT I, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the New Hampshire Republic affirm: Be it known to all courts, governments, and other parties that: Being a person of Strong Christian Morals, it is against my Deep, Sincerely Held, Religious Convictions to accept the injection of any foreign substance into my Body. This includes, but is not limited to, any and all, Vaccinations, Shots, Tests for Diseases, Oral Vaccines, Epidermal Patches and in any other way that Live or Killed Bacterium, Viruses, Pathogens, Germs, or any other Microorganisms, may be introduced into or upon my body. This written statement to exempt myself from the immunization requirement, and the Mantoux (PPD) Tuberculin Test, because I hold genuine and sincere personal religious beliefs which are inconsistent with these medical procedures and experimentation. The practice of vaccination and the injection of any foreign substance is contrary to my conscientiously held religious beliefs and practices, and violates the free exercise of my religious principles. The attenuated virus used to produce the Rubella vaccine (RA27/3) was obtained from an aborted fetus and then cultivated on fetal tissue from another aborted baby (WI-38), and is also in the rubella portion of the MMR-II vaccine. The Chickenpox vaccine containing WI-38, MRC-5 and Hepatitis-A vaccine (MRC-5) were obtained from human babies that were electively aborted. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of abortion. The acceptance of these vaccines promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill". The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith. I, {First and Last name}, am exercising my rights under the First Amendment of the US Constitution and [insert New Hampshire college exemption statute here] to receive Religious Exemption from Vaccination & testing. 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. The Lord Jesus Christ and Our Creator are the only source of protection of my body and that of my family that I can accept. I affirm that vaccination & injections of foreign proteins conflict with my religious belief as stated above. Therefore, I would request that you accommodate my religious beliefs and practices by exempting me from the college vaccination and TB testing requirement. Rest assured that I do practice a form of immunization that keeps my immune system strong and is in keeping with Biblical principles. Further Affiant Saith Not The use of notary below is for identification only, and such use does NOT grant any jurisdiction to anyone. Subscribed and sworn, without prejudice, and with all rights reserved, (Print Name Below) _______________________________________________________________, Principal, by Special Appearance, in Propria Persona, proceeding Sui Juris. _______________________________ Signature of Affiant ACKNOWLEDGMENT state of New Hampshire county of _________________: On this _______ day of ______________, 200__, before me personally appeared __________________________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged that he executed the same as his free act and deed, for the purposes therein set forth. _______________________________________ (Notary Public) My Commission Expires ______________________________, 200___ These Google searches are mostly the college and school exemptions. There are always new forms coming online. Keep a regular check on these to look for newly added forms. Some are for daycare too. The links are the actual keywords that are used. Immunization Exemption Form Vaccine Exemption Form Immunization Waiver Employment: Most of these are the Hepatitis B vaccine declination forms, such as the OSHA form. There are hundreds of these forms. Rather than linking to each one, here are the Google Search results for these keywords. There are other vaccines that one can decline that are worded like the OSHA forms. Vaccine Declination Form or Hep B vaccine waiver TB Test: TB Testing Exemption Letter:  HTMLSample 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_.pdfLead Testing Exemption Letter: HTMLSample 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! TB Testing Alternatives... 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 request a printout with the results. Here are some of the practitioners for New Hampshire New Hampshire BEST™ BioMeridian Practitioners: Please call contact below to find 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 New Hampshire QXCI Practitioners: http://www.theqxci.com/practitioners.php 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 1-888-249-1421. Immunization Registry Opt-Out: New Hampshire Immunization Registry Exemption info http://www.generalcourt.state.nh.us/rsa/html/X/141-C/141-C-20-f.htm
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