Do Not Sign
AAP or other self-incriminating Vaccine Refusal forms
Basically, some doctors are giving patients who choose not to vaccinate their children a form to sign created by the
American Academy of Pediatrics (AAP). This form varies somewhat from state to state but basically it is a
total propaganda sheet about the alleged
value of vaccines, the alleged "risk" of not vaccinating and, even worse, the parent who signs the form is
falsely "admitting" that they are
putting their children at risk.
Lower on this page we have a letter from our director that explains more about why self-incriminating forms are to be avoided.
When faced with a request to sign a form which removes liability from your doctor, you have several options:
OPTIONS
- Change doctors to a holistic physician such as a naturopath, homeopath or other medical provider who does not require
you to remove
the liability from their shoulders in the event your child becomes sick.
- Write your own form letter.
- Use our form 'as is' or modify it to reflect your needs.
WARNING/DISCLAIMER: Please note that the law varies from state to state. Thus we HAVE NOT asked the advice of a lawyer about what unforeseen
consequences might arise from using this form.
If you do consult a lawyer in your state about using our form, please share with us the comments you receive. Thanks.
RefuseVaccines1.doc [MS Word 25K]
RefuseVaccines1.pdf [Adobe PDF 87K]
Note: the intention of this above form is
- To give the doctor release from liability in case your child acquires what allegedly is a 'Vaccine Preventable Disease'.
- To avoid the creation of liability for yourself.
- To give the doctor a little bit of information to make them think.
- To put 'concerned parties' on notice that you have done your homework.
The form above avoids telling the doctor why you choose not to vaccinate.
Your reason for not vaccinating is your affair, unless you choose to divulge it.
For example, you might want the doctor to know that your religion forbids certain treatments.
The letter below is from our director, Ingri Cassel, and it explains why you should not sign any self-incriminating form.
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:
https://iris.idhw.state.id.us/irisweb/pdf/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.
For more background on the problem of self-incriminating Vaccine Refusal forms see this offsite page:
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http://anairhoads.org/medical/saynotovaccines.shtml