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Ohio State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page |
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New Born Issues:Click for the desired information for your state Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits School-Daycare-Preschool Issues: Schools [all] | 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: 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 Any minor child, through the child's parent or guardian, may submit to the institution authorities certificate signed by the child's parent or guardian whose religious, philosophical, or moral beliefs are opposed to such immunization. The minor child is then exempt. |
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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.
Affidavit - Birth Exemptions
HTML (simple text) Affidavit to modify. AFFIDAVIT in Microsoft Word Replace the paragraph (near bottom of page 1) of the generic AFFIDAVIT above with your state law as follows: [Make sure you replace with your name, status, and name of child.] (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 , Ohio Rev. Code Ann. § 3701.501(A)(2) and §3313.671 to receive Religious Exemption from Vaccination, ALL injections, & testing. 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 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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New Born Screening - Ohio Religious Exemption from newborn screening allowed. Ohio Rev. Code Ann. § 3701.501 § 3701.501. Screening of newborns for genetic, endocrine, and metabolic disorders; advisory council. (A) (1) Except as provided in division (A)(2) of this section, all newborn children shall be screened for the presence of the genetic, endocrine, and metabolic disorders specified in rules, adopted pursuant to this section. (2) Division (A)(1) of this section does not apply if the parents of the child object thereto on the grounds that the screening conflicts with their religious tenets and practices. New Born Screening - General for USA 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) ncsl.org/IssuesResearch/Health/NewbornGeneticandMetabolicScreeningLaws/tabid/14416/Default.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 |
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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/vac_refusal_forms.aspx 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
DayCare See Stateforms below for religious exemption. For a medical exemption, see the link found at: http://www.ohiovaxinfo.jessicas-haven.com/exemptions/index.html from the Ohio DJF: Ohio Department of Jobs and Family Services - From the bottom of the form "This is an optional form provided by JFS which may be used by child care centers and type A homes to meet the requirements of Rules 5101:2-12-37 and 5101:2-13-37." A type A home is an in-home daycare where the licensed owner of the daycare has a contract with the county JFS to provide daycare.
Preschool See Stateforms below.
Kindergarten & Schools See Stateforms below. State Froms
State Form Required: No.Public school districts: Schools with specific forms: Perrysburg, Sandusky, Delaware and Massillon See below. Generic Forms: May be used for any school Tuscarawas Valley Local Schools (.doc) Immunization_Exemption_Form.docMillford Exempted Village Schools State of Ohio Legal Immunization Exemption (.pdf)
(.pdf) http://vaccines-ohio.4t.com/Exemptions/immunizationexemption.pdf (This form is generic, and may be used for other schools.) Black River Local School District Sullivan, OH 44880 IMMUNIZATION RELIGIOUS, GOOD CAUSE, AND MEDICAL EXEMPTION FORM Ohio Revised Code, Sections 3313.671, Part (3) and (4) (.pdf) http://www.blackriver.k12.oh.us/pdf/med_exemption_form.pdf(This form is also generic, and may be used for other schools.) Defiance City Schools (Generic Form 5320 F1) (.pdf) http://vaccines-ohio.4t.com/Exemptions/Defiance-exempt.pdf Note: membership in a specific denomination is not required and most Ohio exemption forms do not list "Denomination" in connection with religious exemption. Sample Exemption letter http://ohiovaxinfo.jessicas-haven.com/exemptions/sample_letter.html Ohio Exemption letter (Simple, short and to the point. Modify to suit your facts.) http://vaccines-ohio.4t.com/Exemption.html (Insert Date) (Address to your local Board of Education) §3313.671 - Required Immunizations; Exceptions B.4 A pupil who presents a written statement of the pupil's parent or guardian in which the parent or guardian objects to the immunization for good cause, including religious convictions, is not required to be immunized. To Whom It May Concern: After listening to many debates; reading a variety of articles, facts, and personal accounts; and personally interviewing numerous authorities on either side of the vaccine issue, I have decided that vaccines are not in the best interest of my child, _______________________. Thank you, (sign here) Schools with specific forms: Perrysburg School System (.pdf)http://vaccines-ohio.4t.com/Exemptions/Perrysburg-exempt.pdf Sandusky City Schools, Form 039 IMMUNIZATION EXEMPTION (.pdf) http://www.sandusky-city.k12.oh.us/Downloads/Form%20039%20Immunization%20Exemption2.pdf Massillon City Schools IMMUNIZATION EXEMPTION FORM (Religious, Good Cause and Medical) Amended Substitute Senate Bill No. 282, Ohio Revised Code, Sections 3313.671, part (3) and (4) (.pdf) http://www.neola.com/massillon-oh/search/forms/fm5320F2.pdfDelaware City Schools Adobe Acrobat PDF (.pdf) http://vaccines-ohio.4t.com/Exemptions/Delaware-exempt.pdf (.pdf) http://www.neola.com/delaware-oh/search/forms/fm5320F2.pdf To download the Microsoft Word document,go to Index of /Exemptions and click on the Delaware-exempt.doc http://vaccines-ohio.4t.com/Exemptions/odjfs.pdf
Colleges/Universities
Defiance College Health Services 701 N. Clinton Street Defiance, Ohio 43512 Phone: 419-783-2527 Fax: 419-783-2408 Contact for an application for exemption from immunizations. Case Western Reserve University - Students, researchers, professors (.pdf) http://vaccines-ohio.4t.com/Exemptions/CWRU-exempt.pdf Columbus State Community College - This file is a health statement, the exemption for the Hep B shot is on the third page. (.pdf) http://vaccines-ohio.4t.com/Exemptions/CSCC-health.pdf Lake Erie College Immunization Waiver (.pdf)
http://www.lec.edu/newsite/studentctr/IMMUNIZATION%20WAIVER.pdf
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 - - - - 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
Suggestions for dealing with Employer Mandates.
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)
http://www.fws.gov/forms/3-2283.pdfClick here for an Affidavit for Adult (college & employment religious exemption) ... Edit as needed... |
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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. See QXCI-BioMeridian Providers, etc below |
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Misc Info - QXCI providers - Sponsors - Etc.
Global Quantum Quest; Worldwide EPFX Resource CentreGeneral link for QXCI practitioners in Canada, USA, Africa and The Netherlands. http://theqxci.com/practitioners.php Here are some of the practitioners for Ohio Ohio BEST BioMeridian Practitioners: Health Advocate Services Dr. Ted Suzelis, ND - Naturopathic Physician 38 West Broad Street Newton Falls, OH 44444 Tel: 330-872-1577 http://www.ohionaturopathic.com/ DrTed@Suzelis.com www.healthytreasures.com/has.htm or... Treat Yourself Dr. Ted Suzelis, ND - Naturopathic Physician 3837 Starr Centre Drive Canfield, OH 44406 Tel: 330-533-1870 http://www.ohionaturopathic.com/ DrTed@Suzelis.com http://www.treatyourselfholistic.com Meridian Stress Assessment Testing & Balancing Stephanie Burns P.O. Box 161 Munroe Falls, OH 44262 (near Cuyahoga Falls) Tel: (330) 928-5312 Website: http://www.msatest.com Email: stb@msatest.com Profile: Discover how Chinese Medicine, homeopathy, and technology combine to help your body regain a healthy energetic balance. No needles used. Give your body the support it needs to create an environment for healing to occur. One three-hour session grants you a month's worth of healing energetic support. Wellness Works Holistic Health and Education Center Bruce Doolin, LMT, C.P.F.T, CHt. 1000 Old Henderson Rd., Columbus, Ohio 43220 614-451-WELL (9355) http://www.healthchanges.com/ E-MAIL: brucelmt@aol.com MERIDIAN STRESS ASSESSMENT MSA is used to conduct a comprehensive evaluation of a person's energetic health and balance. This process involves measuring electrical conductivity at responsive points (acupuncture meridian points) on the skin, typically on the hands and feet. These measurements are recorded to help provide a profile of a client's present condition. According to European medical research, acupuncture points are related to the body's organs and organ systems. This system can help the client maintain the structural or functional integrity of important body systems. Dr Andrew P Vitko Chiropractor 466 W Lafayette Rd Medina, OH 44256 Phone: 330-722-6684 http://drandrewpvitkochirop3307226684.worldpages-ads.com/ The Studio 3860 Indian Ripple Rd Beavercreek, Oh 45440 937.306.0052 http://www.thestudioinbeavercreek.com Center for Life Healing Lynn Deen, MBA, Certified Acupressure Therapist 3866 Indian Ripple Road Beavercreek, OH 45440 Work: 937.431.1774 Cell: 937.361.3957 Fax: 937.306.0053 (please call work# or cell# prior to faxing) http://www.centerforlifehealing.com Email: lynndeen@ameritech.net BioMeridian (Meridian Stress Assessment): BioMeridian assesses the health of the meridians (energy pathways) and uses acupoints to test frequencies for pathogens such as mold, bacteria, parasites, chemicals, allergies and much more. SPECIALTIES INCLUDE: Certified Acupressure Therapist, Jin Shin Jyutsu Practitioner, The Reconnection & Reconnective Healing, Certified Okazaki Restoration Practitioner, CranioSacral (CS I/II), Reiki Master/Teacher (through Level IIIA), Healing Touch, Pranic Healing, Bach Flower Essences (Levels I/II), Young Living Essential Oils--Level I, Meridian Stress Assessment Technician, Erchonia Low Level laser Technician. Lynn is also a returning practitioner and teacher on the Sea Angels Cruise Health & Wellness Conference, a spiritual event boasting some of the best psychics, intuitive, clairvoyants, healers, Reiki masters, and advanced mystics the world has to offer.. Dr. Mel Derickson D.C. Barb Derickson L.M.T. 3355 Dayton-Xenia Road Beavercreek, Ohio 45432 937-426-9225 http://www.drmeldericksondc.com melbarb@sbcglobal.net Dr. Mel Derickson uses two of the most powerful tools for nutritional support of the body available today. Meridian Stress Assessment (MSA) and the Symptom Survey Form. 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 Ohio QXCI Practitioners: http://www.theqxci.com/practitioners.php#oh Main page of practitioners: http://www.theqxci.com/information.php Emily Van Doren Bush Prescription for Prevention Individualized holistic health plans and retreats 10764 Hooper Ridge Glouster, OH 45732 740-448-2303 The Natural Wellness Learning Center Elaine Smith Licensed Certified Nutritionist Herbalist, Holistic Practitioner 25412 McCoy Rd. Freeport, Oh 43973 740-758-5236 nundwk@lst.net Transformational Healing Center Harvey Bank Specializes in learning disabilities, autism, allergies, clinical nutrition, body work, vibrational healing, pain control and elimination as well as physical and mental counseling services. 1330 East High St. Springfield, Oh 45505 937-324-4660 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. The L.I.F.E. System is also registered with the FDA for safety issues as a Class 2 Biofeedback Device
New Web site: http://www.jessicas-haven.com/ Jessica's Old Web site: http://vaccines-ohio.4t.com/ |