NEW JERSEY - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)
IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)New Jersey
Current Statutes & Laws: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/newjersey.aspx
Medical & Religious
A written statement should be submitted by the student, or the student's parent or guardian if the student is a minor, explaining how the administration of the vaccine conflicts with the bona fide religious tenets or practices of the student, or the parent or guardian, as appropriate; except that a general philosophical or moral objection to the vaccination shall not be sufficient for an exemption on religious grounds.
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.
N.J. Stat. Ann. § 26:2-111
26:2-111. Testing of infants for biochemical disorders
All infants born in this State shall be tested for hypothyroidism, galactosemia and phenylketonuria. The Commissioner of Health shall issue regulations to assure that newborns are so tested in a manner approved by the commissioner. The commissioner shall ensure that treatment services are available to all identified individuals. The State Department of Health may charge a reasonable fee for the tests performed pursuant to this act. The amount of the fee and the procedures for collecting the fee shall be determined by the commissioner. The commissioner shall apply all revenues collected from the fees to the testing and treatment procedures performed pursuant to this act.
The commissioner may also require testing of newborn infants for other preventable biochemical disorders if reliable and efficient testing techniques are available. If the commissioner determines that an additional test shall be required, 90 days prior to requiring the test he shall advise the President of the Senate, Speaker of the General Assembly and chairmen of the standing reference committees on Revenue, Finance and Appropriations and Institutions, Health and Welfare of his determination.
The commissioner shall provide a program of reviewing and following up on positive cases in order that measures may be taken to prevent mental retardation or other permanent disabilities.
Information on newborn infants and their families compiled pursuant to this section may be used by the department and agencies designated by the commissioner for the purposes of carrying out this act, but otherwise the information shall be confidential and not divulged or made public so as to disclose the identity of any person to which it relates, except as provided by law. The department shall conduct an intensive educational and training program among physicians, hospitals, public health nurses and the public concerning those biochemical disorders. This program shall include information concerning the nature of the disorders, testing for the detection of these disorders and treatment modalities for these disorders.
The provisions of this section shall not apply if the parents of a newborn infant object to the testing on the grounds that it would conflict with their religious tenets or practices.
P.L. 1977, c. 321, s. 2; amended 1981, c.357, s.3; 1988,c.24,s.3.
Hearing Screening...
NEW JERSEY
Statute: 8:19-2.12 (a) This subchapter shall not apply in the case of any infant or child whose parent or guardian objects to the testing on the grounds that testing would conflict with his or her religious tenets or practices. (b) In case of refusal to test pursuant to (a) above, the chief executive officer or responsible physician or birth attendant or home health agency shall assure that documentation of refusal to test becomes part of the infant's permanent medical record. (c) The chief executive officer or responsible physician or birth attendant or home health agency shall assure that a copy of documentation of refusal to test is forwarded to the testing laboratory. [Source: NJ Administrative Code Title 8. Chapter 19]
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)."Alternatives to Vitamin K Prophylaxis...
fatalities=death
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 Birth Plan Letter for Hospital Births for an adopted child...
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
For New Jersey, it would be good idea to use with the AFFIDAVIT below AND model birth plan letter. I hope someone uses this affidavit, model birth plan letter and refusal form, and that it succeeds. We want to hear about it if someone does succeed 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 Massachusetts 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 NJ Administrative Code Title 8. Chapter 19 8:19-2.12 (a), N.J. Stat. Ann. § 26:2-111, NJ State Statute 26:1A-9 1974, and Section 8:57-4.1 N.J.A.C. 1995, 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 Massachusetts
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___
State Form Required: No.
Daycare & Preschools: Use same letter as schools. Good idea to get the exemption notarized.
New Jersey Children's Center at Bankers Trust (Harborside)
http://www.childrenfirst.com/parents/mf_nj.PDF
The exemption is on page 4. This is their own exemption.
Schools:
Sample exemption letter for NJ from Jeff Rense's site
http://www.rense.com/health/no.htm
This is an example of a religious exemption letter. The names/school are fake but it gives great ideas on how to write your own religious exemption.
Mr. & Mrs. John Smith
123 Alphabet Way
Anytown, NJ 12345
(555) 555-5555
Mr. Tom Jones, Ed. D., Director
George Washington School
456 Washington Avenue
Anytown, NJ 12345
(555) 555-0000
Statement of Religious Objection To Immunization
In accordance with NJ State Statute 26:1A-9.1 1974, and Section 8:57-4.4 N.J.A.C. 1995, I hereby certify that the administration of vaccine and other immunizing agents to my child, Breanna Paige Smith, is contrary to my Religious beliefs, held either individually or jointly with others, and I therefore request that my child be exempted from the school immunization requirements of NJ State Statute 26:1A-9 1974, and Section 8:57-4.1 N.J.A.C. 1995.
We believe in God, and that God has created us in his image. In being created in God,s image, we are given his perfect immune system. We are bestowed with His gift, the immune system. I believe it is sacrilegious and a violation of my sacred religious beliefs to violate what God has given us by showing a lack of faith in God. Immunizations are a lack of faith in God and His way, the immune system. I believe that receiving immunizations shows God that I have no faith in His promises of protection for us, saying that I trust man more than His holy words of protection for us. We believe in Jesus, and his many promises of protection for us if we place our trust in Him.
My religious beliefs are also based upon the understanding of what God requires of them as provided for in the Bible. 1 Corinthians 8:6
Yet for us there is one God, the Father, from whom are all things and for whom we exist, and one Lord, Jesus Christ, through whom are all things and through whom we exist. 2 Corinthians 6:16-7:1
For we are the temple of the living God; and God said, "I will live in them and move among them, and I will be their God, and they shall be my people. Therefore come out from them and be separate from them, and be separate from them, says the Lord, and touch nothing unclean; and I will welcome you, and I will be a father to you, and you shall be my sons and daughters, says the Almighty." Since we have these promises, beloved, let us cleanse ourselves from every defilement of body and spirit, and make holiness perfect in the fear of God. Romans 14:14
I know and am persuaded in the Lord Jesus that nothing is unclean in itself; but it is unclean for any one who thinks it unclean. 1 Corinthians 12:24-27
But God has adjusted the body, giving the greater honor to the inferior part, that there may be not discord in the body, but that the members may have the same care for one another. If one member suffers, all suffer together; if one member is honored, all rejoice together. Now you are in the body of Christ and individually members of it. 1 Corinthians 11:29-30
For anyone who eats and drinks without discerning the body eats and drinks judgement upon himself. That is why many of you are weak and ill, and some of you have died. Mark 2:17
And hearing this, Jesus said to them, "It is not those who are healthy who need a physician, but those who are sick; I did not come to call the righteous, but sinners." Mark 10:26-28
And they were exceedingly astonished, and said to him " Then who can be saved?" Jesus looked at them and said, "With men it is impossible, but not with God; for all things are possible with God." 1 Corinthians 2:5
That your faith should not stand in the wisdom of men, but in the power of God. Mark 5:34
And he said to her, "Daughter, your faith has made you well; go in peace and be healed of your disease." Ephesians 2:8-10
For by grace you have been saved through faith; and this is not your own dong, it is the gift of God - not because of works, lest any man should boast. For we are His workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them. Psalms 91:11
For he will give his angels charge of you to guard you in all your ways. Isaiah 58:11
And the Lord will guide you continually, and satisfy your desire with good things, and make your bones strong; and you shall be like a watered garden, like a spring of water, whose waters fail not.
I swear that all the foregoing statements are true to the best of my information, knowledge and belief.
________________________________________________
John Smith - Father
_____________________
DATE
________________________________________________
Jane Smith - Mother
_____________________
DATE
Subscribed and Sworn before me this ________ day of _____________________, 1998.
___________________________________________
ATTORNEY'S SIGNATURE
Short and easy to use Sample letter of Exemption for NJ. Written by an Attorney
http://www.lifespirit.org/immunop.html#Sample
New Jersey: No official state form. A written exemption. May be a good idea to notarize.
See 22 page exemption letter, either HTML or .PDF file. Lots of good information.
http://www.vaclib.org/chapter/cherubs.htm
RELIGIOUS EXEMPTION IN NEW JERSEY (August 13, 2003)
http://www.vaclib.org/chapter/exemptnj.htm
New Jersey Children's Center at Bankers Trust (Harborside)
http://www.childrenfirst.com/parents/mf_nj.PDF
The exemption is on page 4. This is their own exemption.
Another online exemption letter for NJ
http://burwellfamily.us/njexemptform.htm
A parent has already requested an AFFIDAVIT for New Jersey Older Child, so it's copied and pasted here:
AFFIDAVIT
Comes now, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the New Jersey 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 body or any of my children’s bodies.
This written statement to exempt my child from the immunization requirement, the Mantoux (PPD) Tuberculin Test, and other shots/injections, because I hold genuine and sincere personal religious beliefs which are inconsistent with these medical procedures & 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 Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. The Chickenpox (Varivax) vaccine contains MRC-5 and RA 273. 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 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.
(We / I) {First and Last name(s)}, as the {(parent (s) / guardian(s)} of ______________________________(name of child) are exercising our rights under the First Amendment of the US Constitution, New Jersey State Statute 26: 1A-9.1, and with the guidelines in Chapter 14 of the New Jersey State Sanitary Code 8:57-4.4, 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 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 child from any vaccination or injections 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 New Jersey
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___
Colleges & Universities:
"My religious/cultural beliefs prohibit immunizations." (Indicate rationale and attach statement from clergy or other authority.)
Good religious reasons...
These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here or attach rationale.
Often you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities.
Q: What constitutes a religious conflict with vaccination?
A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials.
A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities.
Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue.
A conflict arises if your 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. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from.
The Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. 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 this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The Chickenpox (Varivax) vaccine containing MRC-5 and RA 273, is obtained from human babies that were electively aborted. The acceptance of this vaccine 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.
For a child under age 18, where parent has to make the statement, concerning Hep B vaccine...
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.
”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994]
“The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994]
(Indicate rationale and attach statement from clergy or other authority.)
You do not need to belong to a church or religious organization to claim religious exemption from vaccines.
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.
Click here to use this AFFIDAVIT for Missouri Adult.
You can use that format, and replace Missouri with New Jersey, and add statute, if needed, or use the one below, which has been added to and edited.
AFFIDAVIT for New Jersey Adult (college religious exemption) ... Edit as needed...
AFFIDAVIT
Comes now, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the New Jersey 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 [insert New Jersey college Statute/s here]; 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 New Jersey
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:
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:
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 New Jersey
New Jersey BEST™ BioMeridian Practitioners:
Blairstown Chiropractic and Holistic Wellness Center
18 Stillwater Rd., Blairstown, NJ 07825
Phone: 908.362.8767 | Fax: 908.362.8770
http://www.bccgethealthy.com
New Patient Forms: http://www.bccgethealthy.com/pdf_forms.php
info@bccgethealthy.com
BioSET, Bioenergetic Sensitivity and Enzyme Therapy, is a holistically inspired treatment developed by Dr. Ellen Cutler, D.C., that strengthens the body’s immune response via allergy elimination, proper digestion and nutrition. Using muscle testing, acupressure, detoxification, enzyme therapy and the use of Bio-meridian’s MSA (meridian stress assessment) machine, specific allergies can be identified and treated returning homeostasis to the body.
Healthy Transitions and Education Center, LLC
We are located in Morris County, NJ
For more information or to schedule an appointment please email us at this address Healthytran@aol.com
We offer Nutritional Counseling, Bio Meridian Stress Assessment, Reams Testing, Stress Reduction, Martial Arts Instruction, Health Education Classes, Herbology Classes, Meditation, Reiki, Naturopathy, Drug Screening.
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
New Jersey QXCI Practitioners:
http://www.qxciscio.com/qxci-northeast-coast-usa.html
Evergreen Acupuncture and Herbs
Dorhty Chae
614 Broad Ave.
Richfield, NJ 07657
(also has an office in New York)
718-353-3906
201-945-0022
dott55@aol.com
Jill Tonkovich
Minding The Body Welness Center
Painwork, detox, colon hydrotherapy autism, massage therapy
718 Arnold Ave.
Pt. Pleasant, NJ 08742
732-892-7566
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.
Ellen Sweeney, director
357 Schindler Drive
Brick, NJ 08723
(732) 451-1606
E-mail: NJVaccineInfo@comcast.net
http://groups.msn.com/ParentsforAutismAutoimmuneandVaccineEducation