ILLINOIS - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)
IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)Illinois
Current Statutes & Laws: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/illinois.aspx
Medical & Religious
"Parents who object to health examinations or any part thereof, or to immunizations, on religious grounds shall not be required to submit their children or wards to the examinations or immunizations to which they so object if such parents or legal guardians present to the appropriate local school authority a signed statement of objection, detailing the grounds for the objection"
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.
Religious Exemption from newborn screening allowed.
Ill. Rev. Stat. ch. 410, 240/3
PUBLIC HEALTH (410 ILCS 240/) Phenylketonuria Testing Act.
(410 ILCS 240/3) (from Ch. 111 1/2, par. 4905)
Sec. 3. The provisions of this Act shall not apply when parent or guardian of the child objects thereto on the grounds that such test conflicts with his religious tenets and practices. A written statement of such objection shall be presented to the physician or other person whose duty it is to administer and report such tests under the provisions of this Act.
(Source: Laws 1965, p. 284.)
http://www.legis.state.il.us/legislation/ilcs/ilcs... E
Hearing Screening...
ILLINOIS
Statute: Section 25. Objections to test. The provisions of this Act shall not apply when the parent or guardian of the newborn infant objects to hearing screening on the grounds that the screening conflicts with his or her religious beliefs and practices. [Source HB 596, 1999]
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://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)."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.
fatalities=death
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 From this website... http://www.vaccines.bizland.com/letters.htm
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
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...
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...
Model letter for hospital births 2.doc (11426)
Model letter for hospital births for adoptions -- Dear Doctor and Medical Staff.doc (11427)
VaccineTruth.net/letters/Model letter for hospital births for adoptions.doc
Or you can do your own model birth plan letter online...
Hospital Birth Preference Plan ~ Birth Naturally, LLC
http://www.birthnaturally.org/GentleBirth/hospitalplan.htm
The birth plan arrangements and letter should be turned in before delievery date.
This “Refusal to Permit Medical Treatment” form is optional to use.
“Refusal to Permit Medical Treatment” form
Refusal to Permit Medical Treatment. A generic form.
../letters/refusal_treatment.pdf
It would be good idea to use with the AFFIDAVIT below AND model birth plan letter. We hope someone uses this affidavit, model birth plan letter and refusal forms, and succeeds. We want to hear about it when someone is successful with this. 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!
Birth plan religious AFFIDAVIT text below. Use with model birth plan letter and/or refusal forms, and edit as needed...
AFFIDAVIT
Comes now, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the Illinois Republic. 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 or the Body of my Children. 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 newborn's body.
This written statement to exempt my newborn from any immunizations, newborn screening, and the Vitamin K shot, because I 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 conscientiously held religious beliefs and practices, and violates the free exercise of my religious principles.
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.
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 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 rights under the First Amendment of the US Constitution and Ill. Rev. Stat. ch. 410, 240/3, Section 25 [Source HB 596, 1999], and 77 Illinois Administrative Code 655.510 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.
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 any foreign substances and proteins conflict with my religious beliefs as stated above. Therefore, I would request that you accommodate my religious beliefs and practices by exempting my newborn child from any vaccinations, injections and testing of any kind.
Rest assured that my family and I 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 Illinois
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___
Daycare & Preschools:
Illinois Religious exemption letter.doc
IllinoisReligiousexemptionletter.doc (larger font)
VaccineTruth.net/letters/Illinois Catholic Religious Exemption letter.doc
VaccineTruth.net/letters/Illinois Catholic religious exemption for VARIVAX.doc
To whom it may concern:
Re: Religious Exemption
In accordance with 77 Illinois Administrative Code 655.510, we hereby state that as parents, based on our religious beliefs, we object to the following vaccinations, including but not limited to: diphtheria, pertussis, tetanus, (DPT, DTaP), poliomyelitis, measles, rubella, mumps (MMR), varicella, Hib, hepatitis B for our child
___________________________________.
Our family’s personal religious beliefs prohibit the injection of foreign substances into our bodies. We believe that the Holy Bible teaches that parents are responsible for the care of their children. We believe that we cannot willfully go against the law of God, and fully put our trust in Him for our child’s health.
Vaccines contain foreign substances that are dangerous to humans.
The Bible teaches that we shall keep the blood pure, and keep the seed from being mixed. Obviously, when genetic materials from bacteria, viruses, yeast, animals, birds, and other humans are injected during vaccination, the blood gets contaminated, and genetic changes occur. God warned not to do this. To do so would violate these teachings of the Bible. Our objection is based on our deeply-held religious beliefs.
The rubella vaccine contained in the MMR immunization was developed from cell lines derived from human embryos. 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).
The Chickenpox vaccine containing WI-38, MRC-5 and Hepatitis-A vaccine (MRC-5) were obtained from human babies that were electively aborted.
The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps our parental authority to condemn such activity in our child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith.
The VARIVAX vaccination is cultured on aborted fetal tissue cell lines WI-38 and MRC-5, which were obtained through human babies that were electively aborted. Our personal religious beliefs hold abortion to be against the will of God. “Thou shalt not kill” scripture tells us in Exodus 20:13.
The vaccination of our child violates laws put forth within us by a higher power at the time of conception.
Our personal religious beliefs include our obedience to God’s law, and we believe that we are responsible before God for the life and safety of our child, created by God.
Sincerely,
Schools:
Sample Religious Vaccination Exemption
http://www.vaccineawareness.org/information/Sample...
Illinois Religious exemption letter.doc
IllinoisReligiousexemptionletter.doc (larger font)
VaccineTruth.net/letters/Illinois Catholic Religious Exemption letter.doc
VaccineTruth.net/letters/Illinois Catholic religious exemption for VARIVAX.doc
Religious Exemptions to Health Examinations Statute
*105 ILCS 5/27-8.1(8) states: Parents or legal guardians who object to health examinations or any part thereof, or to immunizations, on religious grounds shall not be required to submit their children or wards to the examinations or immunizations to which they object if such parents or legal guardians present to the appropriate local school authority a signed statement of objection, detailing the grounds for the objection. If the physical condition of the child is such that any one or more of the immunizing agents should not be administered, the examining physician responsible for the performance of the health examination shall endorse that fact upon the health examination form. Exempting a child from the health examination does not exempt him from participation in the program of physical education training provided in Sections 27-5 through 27-7 of this Code [105 ILCS 5/27-5 through 105 ILCS 5/27-7].
http://www.isbe.net/pps/guidelines.htm
Chicago Public Schools Policy Manual
Title: HEALTH EXAMINATIONS AND IMMUNIZATIONS, BRING INTO COMPLIANCE
WITH ILLINOIS SCHOOL CODE
Section: 704.1
Board Report: 94-1026-PO1 Date Adopted: October 26, 1994
http://policy.cps.k12.il.us/documents/704.1.pdf
Waiver
Children whose parents or legal guardians object on religious grounds to health examinations or any part thereof or to immunizations, shall not be required to submit their children or wards for health examinations or immunizations if such parents present to the local school a signed "Waiver Form" which contains
(1) a statement of objection, and,
(2) details of the grounds for objection. A waiver exempting the child may also be submitted if the physical condition of the child is such that any one or more of the immunizing agents should not be administered; however, the examining physician responsible for the performance of the health examination shall endorse such fact upon the health examination form.
www.dhs.ca.gov/pcfh/cms/chdp/directory.htm
Colleges & Universities:
State of Illinois College Immunization Code...
Effective 7/1/02, the College Immunization Code has been amended (Section 694.210) to allow for a religious exemption based on the personal religious beliefs of students or their parents. Click HERE for more information.
The State of Illinois College/University Immunization Law (77 ILL.ADM.CODE 694) requires all college students born after 1956 to submit immunization information before registration unless you have a medical or religious exemption. If you do not submit documentation showing your immunizations, the College is required to place you on medical hold. This will delay your registration.
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
IMMUNIZATION EXEMPTION - RELIGIOUS
http://www.siue.edu/HEALTH/forms/religious_exemption.doc
Southern Illinois University Edwardsville Health Service Physician Statement for Medical Exemption
http://www.siue.edu/HEALTH/forms/medical_exemption_form.doc
Aurora University Medical Exemption - http://www.aurora.edu/wellness/forms/exemption.pdf
Millikin University, 1184 W. Main St., Decatur, IL 62522, 1-800-373-7733
Millikin University Religious Exemption Petition Form
http://www.millikin.edu/health/forms/religious_exemption.pdf
AFFIDAVIT for Illinois Adult (college religious exemption) ... Edit as needed...
AFFIDAVIT
Comes now, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the Illinois Republic. 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 77 ILL.ADM.CODE 694.210 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.
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 Illinois
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:
You may use the AFFIDAVIT for Illinois Adult above, take out college code and edit as needed.
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:
Yes for Aurora University, no exemptions for TB test.
Yes, required for Augustana College.
Rock Island, Illinois
TB Testing Exemption Letter:
HTML
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.htm
MS .DOC
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.doc
Lead Testing Exemption Letter:
HTML
Sample Exemption Letter for Lead testing. May be modified to your use. http://www.vaclib.org/letters/Lead_testing_waiverGen.htm
MS .DOC
Sample Exemption Letter for Lead testing. May be modified to your use. http://www.vaclib.org/letters/Lead_testing_waiverGen.doc
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 ask specifically for a pathogen scan, especially TB. You will also need to request a printout with the results.
Here are some of the practitioners for Illinois
Illinois BEST™ BioMeridian Practitioners:
Reverend Maggie Fox
2542 S. 7th Ave.,
North Riverside, Il.
Healing Earth Resources
3111 N. Ashland in Chicago
Chicago, Illinois 60657
Call to schedule an appointment
Phone: 708-870-1815
http://www.healingearthresources.com
Doctors' Center for Integrative Wellness
Jennifer Larsen
1045 Burlington Ave.
Lisle, IL 60532
630-960-9355
http://www.dciw.net
Email: info@dciw.net
Meridian Stress Assessment (MSA) -- An innovative, non-invasive, computerized assessment tool that reveals patterns of stress in a patient’s organ systems and suggests ways to restore them to balance. Jennifer Larsen, is an expert X-ray technician who also has extensive knowledge about the Meridian Stress Assessment system.
Restorative Health Care, PC
Meridian Stress Assessment
751 Roosevelt Road
Building 7, Suite 100
Glen Ellyn, IL 60137-5905
By phone: (630) 942-1234
By fax: (630) 942-8855
http://www.reshc.net
To schedule an appointment: appointments@reshc.com
For all other questions: officemgr@reshc.com
To reach Dr. Heather: dr_heather@reshc.com
To reach Tara: tara@reshc.com
Locke Chiropractic & Wellness Center
Dr Aldridge Locke and Dr Ruth Locke
2060 Ridge Road
Homewood, IL 60430
Phone: 708-798-5625
They are trained in the following:
Bio Meridian Stress Assessment
Nambudripad's Allergy Elimination Technique
Vitamins and Nutrients
Acupuncture
Face Breast, and Tummy Lift with Acupuncture
http://www.lockechiropractic.com
Meridian Stress Assessment (MSA
Is a technique that tests skin resistance along the meridian pathway related to organ function. It has the ability to determine stressed, weakened, and balanced meridians. It has the technical ability to suggest remedies and /or nutritional supplements to restore balance.
Dr. Kent Christianson
1620 Pebblewood Lane - Suite 112
Naperville, Illinois 60563
(630) 548-0700
http://www.drkent.com
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
Illinois QXCI Practitioners:
http://www.qxciscio.com/qxci-illinois-il.html
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:
What if a patient does not want to participate in TOTS?
A patient, or a child’s parent or guardian, must give consent to be included in the statewide registry. If consent is not given to participate in the statewide registry, the patient can still be included in your local TOTS system. However, this patient’s information will NOT be shared outside your local system.
http://www.idph.state.il.us/health/infect/totsfs.htm
