Medical Exemption Form

ADVERTISEMENT

Medical Exemption Form
To the Superintendent of the ___________________________School District:
I am the parent of _________________________________________________.
I object to the following procedures for my child(ren) on religious grounds or on the basis
of strong moral or ethical conviction similar to a religious belief:
_______ immunizations
_______ medical examinations
_______ dental examinations
Sincerely,
Date: ____________

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Medical Exemption Form Medical Exemption Form Financial
Medical Exemption Form Medical Exemption Form Financial
Medical Exemption Form Medical Exemption Form Financial
Vaccination Medical Exemption Form Vaccination Medical Exemption Form Financial
Time Limit Medical Exemption Form - Coalition Against Hunger Time Limit Medical Exemption Form - Coalition Against Hunger Financial
Abawd Time Limit Medical Exemption Form Abawd Time Limit Medical Exemption Form Financial
Hepatitis A Immunization Medical Exemption Form Hepatitis A Immunization Medical Exemption Form Financial
Immunization Non-medical Exemption Form - Religious And Personal Belief Immunization Non-medical Exemption Form - Religious And Personal Belief Legal
Medical Immunization Exemption Form Medical Immunization Exemption Form Financial
Form 139 Imm - Medical Exemption Request - Mississippi State Department Of Health Form 139 Imm - Medical Exemption Request - Mississippi State Department Of Health Financial

Related Categories

Parent category: Financial
Download
Go