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

Note: Be advised that websites and links change constantly. It would be wise to go through this page and save ALL the exemption forms and letters, in case a website goes down. Please share with others who also want to refrain from medical experimentation.

Main Sections of this web page
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits

School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry

Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry

Misc_Info, Sponsors, etc.

Statutes/Laws
StateLaw  |   Exemptions  |   PDF-Reader

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 and  &  Philosophical


§ 252.04(3) The immunization requirement is waived if the student, if an adult, or the students parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the person's right to a waiver under this subsection.


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]


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

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.

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
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) VaccineTruth.net/letters/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.

Word-Document AFFIDAVIT in Microsoft Word (.doc) format. (may be modified)

If your Title and Paragraph number of your state law is not pasted above, click here for the link to your state law.


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

Merck Vitamin K Package Insert - Aquamephyton PI | Scribd

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 safe alternative that your chiropractor or naturopath can order for you. Or order directly from Amazon.com

Biotics Research, Bio-K Mulsion - 1 fl oz

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.


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.

Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage:
(.pdf) http://drtenpenny.com/wp-content/uploads/2012/06/Hep_B_in_the_hospital_1_.pdf
This form is generic. It can be used in some of the other states.

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


Newborn 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/sites/genes-r-us/files/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


Wisconsin Specific Information

Religious Exemption from newborn screening allowed.
Wis. Stat. Ann. § 253.13

Health Professionals Guide to Newborn Screening:
(.pdf) http://www.slh.wisc.edu/newborn/newsletters/documents/nbsguide.pdf

Parent Refusal of Newborn Screening Testing Parents may refuse newborn screening testing of their baby ONLY "on the grounds that it conflicts with their religious tenets and practices." Parents refusing under this condition should sign a statement that is placed in the infant's medical record.

Newborn Screening Statue WS 253.13
(3) Exceptions.
This section shall not apply if the parents or legal guardian of the child object thereto on the grounds that the test conflicts with their religious tenets and practices. No tests may be performed under sub. (1) or (1m) unless the parents or legal guardian are fully informed of the purposes of testing under this section and have been given reasonable opportunity to object as authorized in this subsection or in sub. (1m) to such tests.

253.13(3) (.pdf) http://www.legis.state.wi.us/statutes/Stat0253.pdf (page 9)
Birth plan religious AFFIDAVIT text below. Use with model birth plan letter and/or refusal forms, and edit as needed...

AFFIDAVIT

I/We, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being(s), state Citizen(s) of the Wisconsin 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://vaclib.org/chapter/inserts.htm#vitK
"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 , WS 253.13(3) and Wisconsin Statute § 252.04(3) 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 Wisconsin

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___


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

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!

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 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.


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

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

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/


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

DayCare - Schools - Colleges
DayCare-K-12-Colleges
State Form Required:   No

DayCare  |   K thru 12  |   Colleges

DayCare & Preschools
§ 252.04(3) The immunization requirement is waived if the student, if an adult, or the student's parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the person's right to a waiver under this subsection.

The Wisconsin Student Immunization Record has a
check box for Religious reasons for exemption and another
check box for personal conviction exemption to vaccination. You can down load the the form here:
http://www.dhs.wisconsin.gov/forms/F0/F04020L.pdf
Check the appropriate box and submit the form to the facility or school and that should be all you need.



WISCONSIN STATUTE § 252.04(3)

§ 252.04(3) The immunization requirement is waived if the student, if an adult, or the student's parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the person's right to a waiver under this subsection.


Kindergarten & Schools

§ 252.04(3) The immunization requirement is waived if the student, if an adult, or the student's parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the person's right to a waiver under this subsection.

The Wisconsin Student Immunization Record has a
check box for Religious reasons for exemption and another
check box for personal conviction exemption to vaccination. You can down load the the form here:
http://www.dhs.wisconsin.gov/forms/F0/F04020L.pdf
Check the appropriate box and submit the form to the facility or school and that should be all you need.


Colleges/Universities

§ 252.04(3) The immunization requirement is waived if the student, if an adult, or the student's parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the person's right to a waiver under this subsection.

CONCORDIA UNIVERSITY WISCONSIN
Refusal to Receive Hepatitis B Vaccine on bottom of Page 16
(.pdf) http://www.cuw.edu/programs/athletictraining/assets/applicationpacket.pdf

Edgewood College. Madison, Wisconsin
EDGEWOOD COLLEGE IMMUNIZATION EXEMPTION FORM
(.pdf) http://www.edgewood.edu/Portals/0/pdf/ParentsFamily/immunizationexemptionform.pdf

LAKELAND COLLEGE
MENINGOCOCCAL VACCINE WAIVER
(.pdf) http://www.lakeland.edu/Catalog/StudenServices/HealthServices/Waiver.pdf


University of Wisconsin-Eau Claire • 105 Garfield Avenue • P.O. Box 4004 • Eau Claire, WI 54702-4004
Conscientious and Medical Exemption are on the bottom of page.
(.pdf) http://www.uwec.edu/shs/forms/
(.doc) http://www.uwec.edu/SHS/forms/upload/Student-Immunization-Record.doc
(.doc) Meningococcal-Hepatitis B Waiver Form
http://www.uwec.edu/SHS/forms/upload/meningitis_hepB_waiver_form1.dot


UW-Stout Student Health Services
Menomonie, Wisconsin 54751
Immunization Record and Recommendations
(.pdf) http://www.uwstout.edu/healthandsafety/studenthealth/upload/Immunization-Record-and-Recommendations.pdf
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


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

Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

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 below 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


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

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/QuantiFERON_TB_Gold_testimony

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.


TB Test:

TB Test required at University of Wisconsin-La Crosse

TB Test required for
The Medical College of Wisconsin
8701 Watertown Plank Road
P.O. Box 26509
Milwaukee, WI 53226

School Employees:

Wisconsin Statute 118.25 (2) (b) Health examinations.

(b) Such physical examinations, chest X-rays, or tuberculin tests shall not be required of any school employee who files with the school board an affidavit setting forth that he depends exclusively upon prayer or spiritual means for healing in accordance with the teachings of a bona fide religious sect, denomination or organization and that he is to the best of his knowledge and belief in good health and that he claims exemption from health examination on these grounds. Notwithstanding the filing of such affidavit, if there is a reasonable cause to believe that such employee is suffering from an illness detrimental to the health of the pupils, the school board may require a health examination of such school employee sufficient to indicate whether or not such a school employee is suffering from such an illness. No school employee may be discriminated against by reason of his filing such affidavit.


Here are some of the practitioners for Wisconsin

Wisconsin BEST™ BioMeridian Practitioners:

Please call contact below to find BioMeridian practitioners in your area or closeby.

Innovative Health Clinic
Ann Stanger, M.D.
5005 University Avenue
Madison, Wisconsin 53705
Phone: 608-233-2378
Fax: 608-233-2375
http://annstangermd.com
E-mail: contact@annstangermd.com
Specializing in Longevity Medicine and Natural Hormone Therapy, Dr. Stanger is trained in meridian stress assessment using the BioMeridian machine.
Directions to Our Office: We have prepared directions for you to download. Download our driving directions (PDF)
(.pdf) http://annstangermd.com/pdf/Directions.pdf
* If wanting pathogen testing (TB Test) by BioMeridian, be sure to specify that you want it done ONLY by the BioMeridian Stress Assessment (MSA). Be sure to get the printout to prove the test.

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

Wisconsin QXCI Practitioners:

http://www.theqxci.com/practitioners.php#central

Main page of practitioners:
http://www.theqxci.com/information.php

Jason Siczkowycz, ND
Complete Health, Inc
Naturopathic Doctor, EPFX / QXCI Practitioner
Fees:
$99.00 for one hour consultation and EPFX / QXCI Screening
333 Bishops Way, Suite 144
Brookfield, WI 53005
262-860-1600

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.

Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

OptOutRegistry for Vaccines
and various other Opt-Outs
Vaccine Registry Opt-Outs:

Immunization Registry Opt-Out:

Information sheet:
http://www.cchfreedom.org/files/file/Wisconsin%20-%20Vaccination.pdf‎
Since 2000, everys child born in the State of Wisconsin has been enrolled in the registry using information from the child’s birth certificate, unless the child’s legal guardian requests not to be enrolled.

Wisconsin Immunization Registry (WIR) is an opt out system.
Archived Information:
http://web.archive.org/web/20101126181627/http://prohealthcare.org/pdf/FAQs%2012-16-08.pdf
[FAQ] 11. Can I prevent my/my child’s health care provider(s) from sending immunization records?
Yes, you can prevent your health care provider(s) from sending immunization records in two separate ways:
a. Notify your health care provider that you do not want your/your child’s immunization records sent (ie, you are choosing to “opt-out”).
b. Notify the WIR that you do not want your/your child’s immunizations included in the registry. You can also complete the State’s form Wisconsin Immunization Registry Exclusion. This method is best if you visit multiple providers in the State of Wisconsin. WIR will block any health care provider from sending your immunization records to the registry.

Copy of the form is here:
Wisconsin Immunization Registry Exclusion
http://www.docstoc.com/docs/25075283/WISCONSIN-STATE-IMMUNIZATION-REGISTRY-EXCLUSION
Print or Download from docstoc.com


View, Opt-Out, and Opt-Back In --- Form: Archived
Originally posted at: Pro Health Care Organization
http://web.archive.org/web/20101126181644/http://prohealthcare.org/pdf/WIR%20Form%20English%2012-17-08.pdf

WIRS Information: http://www.ncvhs.hhs.gov/030422p4.pdf

Vaccination Liberation - Wisconsin Chapter

- - - - 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.catholiccitizens.org/content/img/f26422/opt%20out%20notice.pdf

STUDENT OPT-OUT NOTICE - Google Search


Statutes/Laws
New Born Issues: NewBornBirthingPlan&BirthExemptions  |   Waivers_CareInSigning  |   Letters_Forms_Affidavits
School-Daycare-Preschool Issues: Statutes/Laws  |   DayCare_Schools_Colleges  |   Letters_Forms_Affidavits  |   (options) OptOutRegistry
Adult Issues: Employment  |   TB_and/or_LeadTesting  |   (options) OptOutRegistry
Misc_Info, Sponsors, etc.

Misc Info - Sponsors - Etc.