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Vaccine Exemption Form

After reading one or some of the books educating them about the dangers of vaccinations, parents frequently ask how to NOT have to vaccinate their children. We've compiled several common forms below for the state of Indiana for your convenience.

WARNING: Only download and make use of the following documentation if you have educated yourself.  Don’t just blindly follow, either side.

VACCINATION EXEMPTION PURSUANT TO THE INDIANA CODE § 20-17.2-6-11
www.vaclib.org/letters/ExemptionVacLib-Indiana.doc

DayCare & Preschools

see IC 12-17.2-3.5-11.1
Immunizations
www.in.gov/legislative/ic/code/title12/ar17.2/ch3.5.html

Sample Letter that you may modify: Exemption VacLib-Indiana.doc
www.VaccineTruth.net/letters/ExemptionVacLib-Indiana.doc

Kindergarten & Schools

Sample Letter that you may modify: Exemption VacLib-Indiana.doc
www.VaccineTruth.net/letters/ExemptionVacLib-Indiana.doc

Colleges/Universities

Religious objections

You may also use one or both of these to give to your doctor:
http://www.vaclib.org/letters/Letter-to-doctor.doc
http://www.drtenpenny.com/Documents/Vaccine_Refusal_Form.pdf
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Spinal Logic Chiropractic
1300 E. Main St.
Danville, IN 46122
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  • Phone: 317-745-5111
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