• "Exemption from Immunization for Reasons of Conscience" Frequently Asked Questions (FAQs),
   PDF Format  
• Sample letter for requesting an exemption form:  Sample Request for Exemption from Immunizations for Reasons of Conscience,
   PDF Format    MS Word Format  (61 Kb) Online exemption form request (secure web page for requesting exemption forms online )

Exemptions to Immunization Requirements:

Chapter §97.62 of the Texas Administrative Code (TAC) describes the conditions under which individuals can seek exemptions from Texas immunization requirements. Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States.

Guidelines for Requesting an Exemption for Reasons of Conscience

• Written requests must be submitted through the U.S. Postal Service, commercial carrier, fax, or by hand-delivery.
  
  Mailing Address: 
  Immunization Branch
  Department of State Health Services
  Immunization Branch (MC 1946) 
  P.O. Box 149347
  Austin, TX 78714-9347
  
  Hand Delivery:
  Department of State Health Services  
  Immunization Branch (MC 1946)
  1100 West 49th Street
  Austin, TX  78756

Fax:
(512) 776-7544

On-Line:
Via the department's Immunization program Internet website (go to www.ImmunizeTexas.org).

• Hand-delivered requests may be submitted to the DSHS, Immunization Branch, between 8 a.m. and 5 p.m. Mondays through Fridays. ALL affidavit forms will be mailed to you via U.S. Postal Service.
  Important note: no requests will be filled at the time of hand-delivery.
• Affidavit form requests will be processed and mailed within one week from the receipt of the request. If additional information is needed in order to process the affidavit, you will be notified.
• The letter must include the following information:
  • Full name of each child for whom a form is requested (first, middle, and last);
  • Date of birth of each child for whom a form is requested;
  • Parent or legal guardian's signature and complete return mailing address, including zip code; and
  • Number of forms needed for each child (not to exceed five forms per child)
• Electronic mail or telephone requests cannot be processed.
• The official Texas Department of State Health Services affidavit form must be notarized and submitted to school officials. The form must be submitted within 90 days from the date it is notarized.
• The school will accept only official affidavit forms developed and issued by the Texas Department of State Health Services (DSHS), Immunization Branch.  No other forms or reproductions will be allowed.