For additional help with exemptions, birth plan, etc questions: Check our
Vaccination Liberation State Chapterand other resource organizations located in your state.
If your state specific help is not available, Contact us.
- - - Available Exemptions - - -
Medical &
Religious
& Philosophical/Other
Exemption requirements: RS 17:170 E.
No person seeking to enter any school or facility enumerated in Subsection A of this Section shall be required to comply with the provisions
of this Section if the student or his parent or guardian submits either a written statement from a physician stating that the procedure
is contraindicated for medical reasons, or a written dissent from the student or his parent or guardian is presented."
However, recipients of public assistance may only use the religious or medical exemption
RS 46:231.4 C.
A. The secretary of the Department of Children and Family Services and the secretary of the Department of Health and Hospitals shall require each recipient of public assistance of the programs .......
C. No person shall be required to comply with the provisions of this Section if that person or his parent or guardian submits a written statement from a physician stating that the
immunization procedure is contraindicated for medical reasons or if the person or his parent or guardian objects to the procedure on religious grounds. http://legis.la.gov/legis/Law.aspx?d=100601
Updates/News
(NVIC 2024)
HB 46 Prohibits the requirement of receipt of a COVID-19 vaccine as a condition of enrollment or attendance at any public or nonpublic school
COVID-19 vaccine as a condition of enrollment or attendance at any public or nonpublic school Status: ENACTED, signed by Governor Jeff Landry on 6/19/2024; effective 8/1/2024; Act No. 674
(NVIC 2024)
HB 421 Provides students with sickle cell disease management and treatment plan, amendment removed expansion of vaccine tracking system
Status: ENACTED, signed by Governor Jeff Landry on 6/11/2024; effective 8/1/2024; Act No. 616
(NVIC 2024)
HB 908 Prohibits a teacher, school employee or administrator from discriminating against or distinguishing between students based on their vaccination status
Status: ENACTED, signed by Governor on 6/3/2024, effective 8/1/2024; Act No. 460
(NVIC 2024)
SB 133 ENACTED, signed by Governor Jeff Landry & effective 5/28/2024; Act No. 395 - Prohibits WHO, UN, WEF from having any power in LA
Your Choice.
Join thousands of other pioneers in refuting the presumed authority the corporate government has over your life.
Break the presumptions by negating adhesion contracts. Find out if your state's corporate statutes actually apply to you.
Did you sign a contract binding you to adhere to their statutes? Not likely. To learn more,
go to this page. PDF documents (.pdf)
links to (USA States)
Exemptions, Process for Religious Exemption, Health Care Minors can Consent to and calls to action, petitions, etc.
Stand For Health Freedom
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.
Birth Plans GENERAL INFORMATION (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...
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) (.doc)
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.
Louisiana State specific information Medical Treatment Refusal
None at this time.
GENERAL INFORMATION (Medical Refusal Forms and Affidavit)
1. Make an informed choice as far ahead of birth as possible.
2. See the Black box warning in the
FDA Package Insert for the Injection.
3. Know your options: Pre-Birth Diet, Oral Vitamin K, or synthetic Vitamin K Injection.
GENERAL INFORMATION Vitamin K
Vitamin K Injection...
The Question of Vitamin K for Newborns
"Essentially all human infants are born with very low blood levels of vitamin K and, since low amounts of vitamin K crosses into breast milk, levels remain low for several weeks after birth in breastfed babies. The purpose of this natural, universal experience of low vitamin K levels in newborns is not known. ..."
"Mouse and epidemiologic studies indicate that the neonatal “deficiency” of vitamin K, which promotes cell turnover, may actually protect the developing fetus from damaging substances that “escape the primary placental screen.”
Read the rest of the article here:
http://www.thevaccinereaction.org/
The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
Warning
"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%
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.
Informed Consent Defense (2020 Pilot Survey)
Wonderful Graphs comparing various unvaccinated vs vaccinated disease rates for vaccines and Vitamin K at birth
PDF 4.8MB
Louisiana State specific information Hepatitis B
None at this time.
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)_________."
Louisiana State specific information New Born Screening
Religious Exemption from newborn screening allowed. La. Rev. Stat. Ann. § 40:1299.1
§1299.1. Tests A.(1)
A.(1) The physician attending a newborn child, or the person attending a newborn child who was not attended by a physician, shall cause the child to be subjected to tests for
phenylketonuria, congenital hypothyroidism, sickle cell diseases, biotinidase deficiency, congenital adrenal hyperplasia, carnitine uptake defect, long-chain 3-hydroxyacyl-CoA
dehydrogenase deficiency, medium-chain acyl-CoA dehydrogenase deficiency, trifunctional protein deficiency, very long-chain acyl-CoA dehydrogenase deficiency, glutaric acidemia type I,
3-hydroxy-3-methylglutaryl-CoA lyase deficiency, isovaleric acidemia, 3-methylcrotonyl-CoA carboxylase deficiency, methylmalonic acidemia (CBL A,B), beta ketothiolase,
methylmalonic acidemia (MUT), propionic acidemia, multiple carboxylase deficiency, argininosuccinate acidemia, citrullinemia type I, homocystinuria, maple syrup urine disease,
tyrosinemia type I, and other genetic conditions that have been approved by the Department of Health and Hospitals; however, no such tests shall be given to any child whose parents
object thereto. Effective July 1, 2007, cystic fibrosis shall be included in the tests that the newborn child shall be subject to by the physician attending the
newborn child or the person attending the newborn child who was not attended by a physician.
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!
To ALL who choose to partially vaccinate or NOT vaccinate their
children:
We (here in Idaho) are hearing more reports of schools and daycares across our state not
honoring legal and valid vaccine exemptions.
The following article contains very important information as to why you
do NOT want to sign AAP's (state adopted) exemption form:
http://childhealthsafety.wordpress.com/ ...
Older letter regarding exemptions in Idaho (similar to many states today)
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
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.
Black's Law Dictionary - Sixth Edition - the definition of Affidavit. This is the dictionary used by the American Bar Association and all
judges/magistrates/attorneys.
Affidavit - A written or printed declaration or statement of facts, made voluntarily, and confirmed by oath
or affirmation of the party making it, taken before a person having authority to administer such oath or affirmation.
[notary]
Warning: Any affidavit we supply is a suggestion or template for you to modify to fit your beliefs or understanding of facts. The
"facts" are those of the person signing the affidavit.
Some definitions for terms on AFFIDAVIT:
Further Affiant Saith Not
Affiant: a person who makes an affidavit.
Saith: A third person singular present tense of say.
Sui Juris: having full legal capacity to act on one's own behalf : not subject to the authority of another
An Adult Affidavit, with Christian beliefs, is here. (MSDOC file)
Feel free to modify as needed.
Dr. Tenpenny had the following forms on her web site. (Now Archived) The forms are generic and may be used in any state. Check any references that might need updating.
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
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.
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
Exemptions include: parent/guardian waivers for religious or personal reasons,
written statement from physician stating contraindicated medical reasons, shortage of supply of vaccine.
Sample Vaccine Exemption Statement for Louisiana for Philosophical reasons
You can modify for religious reasons. (.doc)
VaccineTruth.net/letters/Louisiana.doc
http://legis.la.gov/Legis/Law.aspx?d=79952 Excerpt:
§170. Immunization of persons entering schools, kindergartens, colleges, proprietary or vocational schools, and day care centers for the first time; immunization of persons entering sixth grade; electronic transmission of immunization compliance reports
...
E. No person seeking to enter any school or facility enumerated in Subsection A of this Section shall be required to comply with the provisions of this Section if the student or his parent or guardian submits either a written statement from a physician stating that the procedure is contraindicated for medical reasons, or a written dissent from the student or his parent or guardian is presented.
F. In the event of an outbreak of a vaccine-preventable disease at the location of an educational institution or facility enumerated in Subsection A of this Section, the administrators of that institution or facility are empowered, upon the recommendation of the office of public health, to exclude from attendance unimmunized students and clients until the appropriate disease incubation period has expired or the unimmunized person presents evidence of immunization.
Sample Vaccine Exemption Statement for Louisiana for Medical reasons
Statement of Exemption:
Under Louisiana Revised Statutes 17:170 Sec E, I hereby claim exemption from the immunization requirement for Medical reasons. (Physician statement for dissent for medical reasons attached.)
I understand that in the event of an outbreak of a vaccine-preventable disease at the location of the educational institution or facility the student attends, the administrators of the educational institution or facility, upon the recommendation of the office of public health, may exclude the student from attendance until the incubation period has expired or I present evidence of immunization.
_____________________________ Student signature _____________________________ Date
_____________________________ Parent or Guardian's signature (if required)
Generally, most colleges should have their own exemption waiver. Some colleges may ask for an additional statement to be attached. If so, you may use the AFFIDAVIT for Louisiana Adult (college & employment religious exemption) below. The AFFIDAVIT below is sufficient for a religious exemption statement from MMR and any other vaccines to post secondary institutions.
Most colleges now have their mandatory waiver for meningitis. The required documentation informs the postsecondary school, and thus the state, that the student has either been vaccinated for meningococcal meningitis or has chosen to decline the vaccine.
All of Louisana colleges and universities have a mandatory form entitled Proof of Immunization Compliance (Louisiana R.S. 17:170 Schools of Higher Learning)
On this form you can check off your exemption and sign. They do ask for the reason to be stated, so you can put it there, or use the AFFIDAVIT as an attachment, if you need to.
If you request an exemption for medical or personal reasons, please check the appropriate blank and provide the information requested. You must state a reason for exemption in the space below. ☐ Medical (Physician’s statement below) ☐ Personal (State reason below)
__________________________________________________________________________
__________________________________________________________________________
I understand that if I claim exemption for personal or medical reasons, I may be excluded from classes (unexcused absences) and other campus activities in the event of an outbreak of measles, mumps, rubella or diphtheria until the outbreak is over or until I submit proof of immunization.
__________________________________________________________________________
Student’s Signature Date
__________________________________________________________________________
Parent or guardian’s signature if the student is under 18 years old Date
Links to Education, RS 17:170, 17:170.1, 17:170.2, 17:170.3 and 17:170.4 can bed found hee: Title RS 17.education
Some of the colleges and universities have the same form listed more than once with different URL's. They are all listed for your convenience.
Office of Graduate Studies and Research
Monroe, Louisiana 71209-0600
Proof of Immunization
get-form/844. (.pdf)
DEPARTMENT OF FINANCE
2163 CEBA
E.J. OURSO COLLEGE OF BUSINESS ADMINISTRATION
LOUISIANA STATE UNIVERSITY
BATON ROUGE, LA 70803 USA
Proof of Immunization Compliance (LOUISIANA R.S. 17:170 SCHOOLS OF HIGHER LEARNING) https://www.lsu.edu/shc/files/immun-comp-form-rvsd-04-2012.pdf
South Louisiana Community College
Lafayette Campus
Admissions: EMT-P
320 Devalcourt St.
Lafayette, LA 70506
and
New Iberia Campus
908 Ember Drive
New Iberia, LA 70560
PROOF OF IMMUNIZATION COMPLIANCE
(Louisiana R.S. 17:170 Schools of Higher Learning)
Page 7 (.pdf)
https://www.solacc.edu/admissions/files/documents/LCTCS%20Immunization%20Waiver%20SLCC.pdf Note the sentence in the form:
I UNDERSTAND THAT MY HEALTH COULD BE NEGATIVELY AFFECTED AND MY LIFE POSSIBLE ENDANGERED BY NOT RECEIVING THE ABOVE
LISTED VACCINES.
Suggest you cross out the word "Not" in the above sentence contained on the Immunization Compliance form.
Tulane University in New Orleans, LA
Students born in the United States who want to request an exemption/waiver from immunizations , visit
campushealth.tulane.edu/immunizations for instructions.
Here are some reasons to put into Reasons for Exemption spaces on any form asking for same.
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.
Oftentimes, 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.
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."
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."
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.
Next (below) in Misc are some QXCI and other practitioners. (If known.)
Misc Info and explanation of QXCI - Etc.
QXCI SCIO EPFX Overview
(The SCIO and the EPFX are the same device.
It is known as the EPFX in the USA and the SCIO world wide.)
Source:
energymedicinereview.com/qxci-scio-epfx.html [Now inactive]
Your Choice.
(.doc) 
(.pdf) 
(.doc)