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Arizona State Exemption Page VacLib.org & VaccineTruth.net Exemption Page |
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Statues/Laws
StateLaw |
Exemptions |
PDF-ReaderLink to state law. National Vaccine Information Center: Link to state law. For additional help with exemptions, birth plan,etc questions: Check our Vaccination Liberation State Chapter and other resource organizations page for help in your state. If your state specific help is not available, Contact us. Available Exemptions Medical & Religious for Day Care Medical & Personal Belief for school. PDF documents (.pdf) A PDF reader is required for PDF Files: Free Foxit Reader 12 MB file size. Or Free Download of Acrobat Reader: [Adobe. 43 MB file size] |
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NewBorn Birthing Plan and Birth Exemptions
BirthExemptions |
Birthing_Plans |
Vitamin_K |
Hepatitis_B |
Eyedrops |
Newborn_ScreeningBirth 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. Steps:
Birth Plans (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... Our best and most itemized birthplan: (.pdf) birthplan-itemized.pdf(HTML) BirthPlan-Itemized for reading on screen. Includes handy small dictionary of terms in the document. Model Birth Plan Letter for Hospital Births. This one is more detailed. 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)
It would be good idea to use the AFFIDAVIT below AND a model birth plan letter from above above.
Affidavit - Birth Exemptions HTML (simple text) Affidavit to modify. AFFIDAVIT in Microsoft Word If your Title and Paragraph number of your state law is not pasted above, click here for the link to your state law. Vitamin K Injection... The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert. "WARNING - INTRAVENOUS USE Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON® (Phytonadione)."Links to prescribing information for Vitamin K: http://vaclib.org/chapter/inserts.htm#vitK 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. 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)_________." If you do get a signature, hold on to the form. See Birth Plans for more information on avoiding Hep B Vaccination at birth Eyedrops Some states require Prophylaxis against Gonococcal OPHTHALMIA NEONATORUM. A discussion of medical and legal issues regarding Silver Nitrate in the eyes of the newborn is here: PDF file: Statutory Law USA: Requiring Silver Nitrate in Eyes of Newborns at: http://www.rbs2.com/SilvNitr.pdf Written by Dr. Ronald B. Standler, attorney in Massachusetts and consultant Blog type discussion of pros and cons of eyedrops for newborn is here: http://answers.google.com/answers/threadview/id/20050.html New Born Screening Arizona: Office of Newborn Screening http://www.aznewborn.com/index.htm Note the link to "Fact Sheet" PDF file at the bottom of the page: http://www.aznewborn.com/pdf/nbs_prog_fact.pdf ARIZONA NEWBORN SCREENING PROGRAM GUIDELINES archived at: http://web.archive.org/web/20070717062305/ 3.9 Parental Refusal of Consent The newborn screening tests are automatically ordered for all infants and performed prior to discharge from the hospital, or immediate care of the practitioner attending the birth, unless consent for the test is specifically refused. Parents/guardians may refuse consent for the newborn screening test for their infant after they have received information about the screening program and acknowledged that they understand the potential risks of refusal. Parental refusal of the newborn screening test must be clearly and prominently documented in the infant’s medical record or birth record. The specimen collection kit documenting the refusal shall be submitted with a completed form to the newborn screening laboratory no later than 24 hours or the next working day after the form is completed. General: U.S. states now require screening of newborn babies for specific diseases. Conditions and legal status of "requirement" of newborn to be screened for each state: National Newborn Screening Status Report - http://genes-r-us.uthscsa.edu/nbsdisorders.pdf Newborn Genetic Screening Privacy Laws (includes links to laws for various states) ncsl.org/IssuesResearch/Health/NewbornGeneticandMetabolicScreeningLaws/tabid/14416/Default.aspx Newborn screening From Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Newborn_screening Federal NewBorn Screening Law (from Families of Spinal Muscular Atrophy) http://www.fsma.org |
| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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Waivers - Take Care In Signing
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! A modified AAP form is posted here that you may wish to use with your doctor: AAPmodified.htm AAPmodified.doc MSWord .DOC file | AAPmodified.pdf PDF file, best for printing. 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.
See:
AnaiRhoads.org Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse |
| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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Letters Forms Affidavits
Links to Model birth plan letters (above).Link to Refusal to Permit Medical Treatment form Links to Affidavit - Birth An Adult Affidavit, with Christian beliefs, is here. (MSDOC file) Feel free to modify as needed. Dr. Tenpenny has the following forms on her web site. The forms are generic and may be used in any state. 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 http://drtenpenny.com/vac_refusal_forms.aspx Sample Vaccine Letters. from www.vaccines.bizland.com/letters.htm archived on VacLib.org/letters/doctor.htm 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 Religious exemption forms will be listed below under Daycare Schools Colleges |
| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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DayCare - Schools - Colleges
DayCare-K-12-CollegesDayCare | K thru 12 | Colleges State Form Required: No
DayCare & Preschools REQUEST FOR EXEMPTION TO IMMUNIZATION CHILD CARE FACILITIES (English and Spanish) (.pdf)
http://www.azdhs.gov/als/forms/ccgh10.pdf
Kindergarten & Schools (.pdf)
http://azdhs.gov/phs/immun/pdf/school-exemption-form.pdf
Request for Exemption to Immunization - School (Spanish) Sequoia Choice - AZ Distance Learning - Mesa, AZ. 85211-1405 (.pdf)
http://scazdl.org/new/forms/waiver.pdf ExemptionVacLib-Arizona.doc (.doc) VaccineTruth.net/letters/ExemptionVacLib-Arizona.doc
Colleges/Universities
Azizona College (only) Exemption form.pdf 7k Note: this form was posted in year 2002. [Check with grade & high schools for forms] Arizona: ADHS Religious Exemption.
Arizona: Schools have on file a form to be filled in by parent/guardian to refuse vaccines on philosophical
grounds.
An Adult Affidavit, with Christian beliefs, is here. (MSDOC file)
Feel free to modify as needed.
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| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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Employment
OSHAStandard 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."See TB Testing below for more information. US Fish and Wildlife Service Form 3-2283 Hepatitis B Immunization Consent/Refusal Form (.pdf)
http://www.fws.gov/forms/3-2283.pdf |
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TB and/or Lead Testing TB-Links/Exemptions Generic letter for Exemption to TB Testing: HTML (text): Exemption-tb-test.html MS Doc file: Exemption-tb-test.doc 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." TB and Lead Testing Links: F L Y E R LETTER Exemption_Letters OSHA_and_TB_test Tubersol Treatment TB_Screening Alternatives/Additional_Information 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. Arizona BEST BioMeridian Practitioners: Cactus Flower Wellness Center David Rupley Jr 5813 N. Oracle Road Tucson, AZ 85704 (520) 293-3751 http://www.cactusflowerwc.com Homeopathy and Meridian Stress Assessment “CONSULTATIONS ARE ALWAYS AT NO CHARGE” The Enlightened Health Institute Energy Integration, LLC 14354 N. Frank Lloyd Wright Blvd, Suite 16 Scottsdale, AZ 85260 480-477-5242 480-477-5243 (fax) http://the-ehi.com/ http://nrizzoroberts.home.att.net nrizzoroberts@worldnet.att.net BioMeridian's MSA-21 is a highly advanced galvanic skin response testing device used for meridian stress assessment. Desert Mountain Health Center Dr. Martha Bergner, D.C. 3816 East Fifth Street Tucson, Arizona 85716 Phone: (520) 296-5899 Toll Free: 877-296-5891 http://www.desertmountainhealth.com E-mail: drmartha@desertmountainhealth.com Valley Integrative Physicians Dr. Bruce H. Shelton, M.D. MD (h) DiHom 14231 North 7th Street Suite A-2 Phoenix, AZ 85022 Phone: 602-504-1000 Fax: 602-504-1008 http://www.drbruceshelton.com/ E-mail: jaclyn@drbruceshelton.com Scottsdale Hyperbaric Medicine P.L.L.C. Dr. William Tikey: (480) 951-1248 Dr. Brandy Pierce: (480) 556-8404 14605 N. 73rd St. Scottsdale, AZ 85260 (480) 556-8404 or (480) 556-8409 Fax: (480) 951-4487 Cellular: (602) 790-7003 http://www.scottsdalehyperbaric.com Email: azhyperbaric@aol.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 Arizona QXCI Practitioners: http://www.qxciscio.com/qxci-arizona-az.html . And here... Lightening Research Judy Denzler, CNC Mobile service available to Scottsdale and surrounding areas EPFX / QXCI Practitioner Specializing in nutrition, weight loss, injury and recovery, stress relief, and depression. 928-474-5680 480-216-9449 (cell) sunresearch@cybertrails.com 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. |
| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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OptOutRegistry for Vaccines
Vaccine Registry Opt-Outs:and various other Opt-Outs - - - - Other Opt-Outs - - - -: Birth Certificate and Marriage License Opt-Out: Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so? See: Marriage Licenses, Birth Certificates & #SSNs Military Recruiters: STUDENT OPT OUT FORM regarding the RELEASE OF NAME, ADDRESS, AND TELEPHONE NUMBER TO MILITARY RECRUITERS (.pdf) http://www.militaryfreeschools.org/PDF/optout2.pdfUNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM SAMPLE ENGLISH - BILINGUAL FORMS FOR OPTING OUT Act to Protect Your Privacy from Military Recruiters Information links and forms at AFSC site STUDENT OPT-OUT - Google Search STUDENT OPT-OUT NOTICE regarding the instruction of sexuality to children: STUDENT OPT-OUT NOTICE Valid in all 50 states (.pdf) http://www.catholiccitizens.org/content/img/f26422/opt%20out%20notice.pdfSTUDENT OPT-OUT NOTICE - Google Search |
| Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits | DayCare_Schools_Colleges | Employment | TB_and/or_LeadTesting | OptOutRegistry | Misc_Info |
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Misc Info - Sponsors - Etc.
Doctors against vaccines VIAL - Arizona ChapterKimberly Medlin, director 7385 E Paseo Escondido Prescott Valley AZ 86314 (928) 775-2653 http://poisonevercure.150m.com/ medlins@cableone.net |