Vaccination Liberation Information

NORTH DAKOTA - IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)

IMMUNIZATION EXEMPTIONS by State (includes current statutes, letters & forms)

North Dakota

Current Statutes & Laws:
http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/northdakota.aspx
Medical, Religious & Philosophical

N.D. Cent. Code § 23-07-17.1 (3) Any minor child, through the child's parent or guardian, may submit to the institution authorities certificate signed by the child's parent or guardian whose religious, philosophical, or moral beliefs are opposed to such immunization. The minor child is then exempt from the provisions of this section.

PDF documents (.pdf)

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Exemption Letters & Forms...

Note: Be advised that websites and links change constantly. It would be wise to go through this page and save ALL the exemption forms and letters, in case a website goes down. Please share with others who also want to refrain from medical experimentation.

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.D. Cent. Code § 25-17-04
(.pdf)
http://ranch.state.nd.us/LR/01/cencode/CCT25.pdf

(.pdf) Second Link
(.pdf) Third Link

On page 92 of the pdf document. Last page.

§ 25-17-04. Testing and reporting requirements. The physician attending a newborn child, or the birth attendant in the case of an out-of-hospital birth, shall cause that newborn child to be subjected to testing for metabolic diseases, in the manner prescribed by the state department of health. A physician attending a patient with a metabolic disease shall report the case to the state department of health. The testing requirements of this section do not apply if the parents of a newborn child object to the testing on the grounds that testing for metabolic diseases conflicts with their religious tenets and practices.

NBS Guidelines for Healthcare Providers Manual
North Dakota Newborn Screening Program
Refusal of Newborn Screening Tests
Refusal Form on Page 7
(.pdf) www.ndhealth.gov/familyhealth/Publications/NBSGuidelinesforHealthcareProviders.pdf

Vitamin K Injection...

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
(.pdf) 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)."
fatalities=death
Merck Vitamin K Package Insert - Aquamephyton PI | Scribd

The package insert should be printed out and used along with the birth plan letter, and your exemption letter or AFFIDAVIT. This shows the hospital or birthing center that you are aware of the risks of Vitamin K injection, and that they should be too.

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. Or go to Amazon to buy.

Biotics Research, Bio-K Mulsion 1 fl oz

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

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.

Hepatitis B Vaccine Refusal from Dr. Sherri Tenpenny's webpage:
(.pdf) http://drtenpenny.com/Documents/Hep_B_in_the_hospital_1_.pdf
This form is generic. It can be used in other states.

(Links to model birth plan letter and acceptance of responsibility)
Acceptance of Responsibility. http://www.vaclib.org/legal/accept1.htm

(.doc) 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...

(.doc) 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)

(.doc) VaccineTruth.net/letters/Model letter for hospital births for adoptions.doc

The above documents can also be made available in WordPerfect (.wpd) format.
Please contact us if you want the model birth plan letters in WordPerfect.

Sample Birth Plan from The Center of Unhindered Living

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.
(.pdf) ../letters/refusal_treatment.pdf

The ideal would be to also use the AFFIDAVIT below AND one of the model birth plan letters shown above. We hope prospective parents will take advantage of this affidavit, model birth plan letter and refusal forms, and succeeds. We would love to hear about your success stories. 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 available in Microsoft Word (.doc) and WordPerfect (.wpd) format.


AFFIDAVIT

I/We, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being(s), state Citizen(s) of the North Dakota Republic affirm: Be it known to all courts, governments, and other parties that:

Being (a person/people) of Strong Christian Morals, it is against (my/our) Deep, Sincerely Held, Religious Convictions to accept the injection of any foreign substance into (my Body/our Bodies) or the Body of (my/our) Child. 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/our) newborn's body.

This written statement to exempt (my/our) newborn from any immunizations, newborn screening, and the Vitamin K shot, because (Iwe) 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/our) conscientiously held religious beliefs and practices, and violates the free exercise of (my/our) religious principles.

The Hepatitis-B vaccine supposedly protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps (my/our) parental authority to condemn such activity in (my/our) child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of (my/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/our) 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/my) rights under the First Amendment of the US Constitution, N.D. Cent. Code § 23-07-17.1 (3), and § 25-17-04 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.

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.

The Lord Jesus Christ and Our Creator are the only source of protection of (my body/our bodies) and that of (my/our) family that (I/we) can accept.

(I/We) affirm that vaccination & injections of any foreign substances and proteins conflict with (my/our) religious beliefs as stated above. Therefore, (I/we) would request that you accommodate (my/our) religious beliefs and practices by exempting (my/our) newborn child from any vaccinations, injections and testing of any kind.

Rest assured that (my family and I/our family) 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 North Dakota

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___

AFFIDAVIT can be copied and pasted into your Word Processing program ready for editing.
We can make them available in both Microsoft Word (.doc) and WordPerfect (.wpd) format.

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

Postnatal - 2 months (first "well baby" visit):

If you do take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware and careful of any forms you sign.

We're referring to those "Refusal To Vaccinate" forms put out by the American Academy of Pediatrics. Go to this page below and find out why signing this form is very dangerous. We all know about these forms and how they can be used to undermine parental rights...
http://www.vaclib.org/legal/donotsign.htm

"By endorsing this particular waiver, parents would essentially be signing an admittance of neglect and or "abuse" for refusing vaccines. The language contained in this waiver could put parents and caregivers in jeopardy down-the-line if they should ever find themselves in the courts due to their child's health problems, when confronted with child protective services, divorce, or just about any matter pertaining to that child that could be used against the parent(s).

Please read any waiver provided by your child's doctor carefully before signing. Instead, offer a formally written and signed letter that simply says that you do not wish to vaccinate your child. If you are unsure of the language in the waiver, buy some time by telling your doctor that you need to consult with a lawyer before signing it. "


Anai Rhoads Ford
Human Rights Journalist
Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse by Anai Rhoads Ford, released 15 November 2005.
http://www.anairhoads.org/

Media Contact (703) 491-1903


Generic Vaccine Refusal Form from Dr. Sherri Tenpenny's webpage.
(.pdf) http://drtenpenny.com/Documents/Vaccine_Refusal_Form.pdf
Go to this page for the Microsoft Word Version.

State Form Required: North Dakota Certificate of Immunization is used. Under "Statement of Exemption To Immunization Law", check off religious, moral, personal, etc... You can get an original from the health dept as there are carbon copies. Or you may make several copies of one of the pdf documents of the form below. Top white copy is turned in to school. Parent keeps yellow copy.

Daycare & Preschools:

(.pdf)
Early Childhood Facility Immunization Requirements 2010 Exemptions

If your school does not have their own immunization exemption form, you may use this one from the
North Dakota Department Of Health
"Statement of Exemption to Immunization Law" on bottom of page 1
(.pdf) http://www.ndhealth.gov/Immunize/Documents/Public/COI.pdf
This is their most current form.

This is the older form from the Department Of Health. It is still accepted by most schools.
(.pdf) North Dakota Immunization Form.pdf
Under "Statement of Exemption to Immunization Law".


"Statement of Exemption to Immunization Law"
In the event of an outbreak, exempted persons may be subject to exclusion from school or childcare facility.

Religious/Philosophical/Moral Belief Exemption:  Parent or guardian of the above named person adheres to a belief opposed to immunizations. (Please check one below.)
                                 Religious                      Philosophical                      Moral


__________________________________________________      __________________
                                (Parent/Guardian)                                                            Date

Medical Exemption is also under the "Statement of Exemption to Immunization Law".

Schools:

(.pdf) 2010 - 2011 School Requirements

If your school does not have their own immunization exemption form, you may use this one from the
North Dakota Department Of Health
"Statement of Exemption to Immunization Law" on bottom of page 1
(.pdf) http://www.ndhealth.gov/Immunize/Documents/Public/COI.pdf
This is their most current form.

This older form is still being used, and accepted by schools.
(.pdf) North Dakota Immunization Form.pdf
Under "Statement of Exemption to Immunization Law".


"Statement of Exemption to Immunization Law"
In the event of an outbreak, exempted persons may be subject to exclusion from school or childcare facility.

Religious/Philosophical/Moral Belief Exemption:  Parent or guardian of the above named person adheres to a belief opposed to immunizations. (Please check one below.)
                                 Religious                      Philosophical                      Moral


__________________________________________________      __________________
                                (Parent/Guardian)                                                            Date

Medical Exemption is also under the "Statement of Exemption to Immunization Law".

Opt-Outs:

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.pdf

UNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM
(.pdf) http://www.militaryfreezone.org/opt_out.pdf

SAMPLE ENGLISH - BINGUAL FORMS FOR OPTING OUT
Act to Protect Your Privacy from Military Recruiters
(.pdf) Bi-lingual Recruitment Opt-Out Form

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.pdf

Entire packet...
(.doc) http://www.mfc.org/respect/Website/Links%20on%20Web%20Page/Opt-Out%20Packet.doc

STUDENT OPT-OUT NOTICE - Google Search

Colleges & Universities:

If your college does not have their own immunization exemption form, you may use this one from the
North Dakota Department Of Health
"Statement of Exemption to Immunization Law" on bottom of page 1
(.pdf)
http://www.ndhealth.gov/Immunize/Documents/Public/COI.pdf

Minot State University
500 University Avenue West
Minot, ND 58707
See: SELF REPORTED IMMUNIZATION EXCEPTIONS
(.pdf) http://www.minotstateu.edu/wellness/sh_immunization_frm.pdf
Online Form for Exceptions Only

North Dakota State University
Measles, Mumps, and Rubella Immunization Requirement
For Medical Exemption Use This one. Check off Medical at the bottom of page.
Measles, Mumps, and Rubella Immunization Documentation
(.pdf) http://www.ndsu.edu/fileadmin/studenthealthservice/mmr.pdf

Certification of Religious, Philosophical or Moral Belief Exception
to the North Dakota State Board of Higher Education
(.pdf) http://www.ndsu.edu/fileadmin/studenthealthservice/religious_exception.pdf
Web Archive Links:
(.pdf) LINK 1
(.pdf) LINK 2
(.pdf) LINK 3
(.pdf) LINK 4
(This will work for ALL of North Dakota Colleges.)
This particular form does ask your reason.
(Explain the basis, in detail, of your religious, philosophical or moral objections to immunization in the space below. You may add extra pages if needed. Identify the length of time you have held this religious, philosophical or moral belief. Also identify whether you are a member of any particular faith, denomination or church which forms the basis for your objection.)

Here are a couple of examples:

We believe as parents we are totally responsible for our child until they become of age. We are very appreciative of the fact the US gives us freedom of choice in worship - immunizations and more. This does not mean that we do nothing - it means we use alternative methods to maintain health. Unlike medical remedies, which have detrimental side-effects, mega-nutritional support poses no such threat.

I/We consider so-called "immunization" which is mandatory to be an unreasonable bodily seizure, from which we are protected under the Bill of Rights, by the fourth amendment to the Constitution.

_____________________________

FOURTH AMENDMENT [U.S. Constitution] - 'The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.'

Unreasonable Searches And Seizures. Non-consensual extraction of blood implicates Fourth Amendment privacy rights. Skinner v. Railway Labor Executives' Ass'n, 489 U.S. 602, 16 ('89) ('this physical intrusion, penetrating beneath the skin, infringes [a reasonable] expectation of privacy'); Schmerber v. California, 384 U.S. 757, 67 ('66) (compulsory blood test 'plainly involves the broadly conceived reach of a search and seizure under the Fourth Amendment').' '[f]or the Fourth Amendment does not proscribe all searches and seizures, but only those that are unreasonable.' Skinner, 489 U.S. at 619; accord Vernonia School Dist. 47J v. Acton, No. 95-590, 1995 WL 373274, at *3 (June 26,'95) ('the ultimate measure of the constitutionality of a governmental search is `reasonableness''). A search's reasonableness under the Fourth Amendment generally depends on whether the search was made pursuant to a warrant issued upon probable cause. U.S. v. Place, 462 U.S. 696, 701 ('83)

You can also use the AFFIDAVIT for North Dakota Adult (colleges) for religious reasons below.

United Tribes Technical College
(.pdf) United Tribes Technical College Immunization/Exemption Form (On United Tribes)
(.pdf) United Tribes Technical College Immunization/Exemption Form (On VacLib.org)
Under "Statement of Exemption to Immunization Law".
This is the ND Dept of Health Immunization Form. (This will work for the other colleges too.)

"Statement of Exemption to Immunization Law"
In the event of an outbreak, exempted persons may be subject to exclusion from school or childcare facility.

Religious/Philosophical/Moral Belief Exemption:  Parent or guardian of the above named person adheres to a belief opposed to immunizations. (Please check one below.)
                                 Religious                      Philosophical                      Moral


__________________________________________________      __________________
                                (Parent/Guardian)                                                            Date

Medical Exemption is also under the "Statement of Exemption to Immunization Law".

The University of North Dakota
http://www.undstudenthealth.com/requirements.html
Exemptions for religious beliefs can be granted based on written requests.
(.pdf) Health History and Immunization Form
This particular health history form is not an actual exemption form, but it does have a check off for exemptions.

Conscientious Exemption: I hereby certify by notarization that immunization against ______________________________________________ is contrary to my conscientiously held beliefs.

Most colleges are requiring students to use their health history forms, which sometimes contain the check off areas for vaccine exemptions on them.
THIS is the (generic) exemption form you can use...
(.pdf) http://www.ndsu.edu/fileadmin/studenthealthservice/religious_exception.pdf

Web Archive Links:
(.pdf) LINK 1
(.pdf) LINK 2
(.pdf) LINK 3
(.pdf) LINK 4

Or you can use this form...
North Dakota Department Of Health
"Statement of Exemption to Immunization Law" on bottom of page 1
(.pdf) http://www.ndhealth.gov/Immunize/Documents/Public/COI.pdf

This one can be used for Higher Educational Institutions or Employment Situations.
North Carolina Adult Religious Exemption from Attorney.doc (11438)
This can be edited to reflect North Dakota. This is in case you are denied a legal exemption.
(.doc) VaccineTruth.net/letters/NorthCarolina11438.doc

If a college asks for an additional statement on one of their forms; you can use this one.
AFFIDAVIT for North Dakota Adult (colleges) TEXT HERE...
AFFIDAVIT can be re-worded and edited to suit your preferences. This is a basic example.

AFFIDAVIT

I, _________________________, Sui Juris, Free, Natural Flesh and Blood Human Being, state Citizen of the North Dakota Republic affirm: 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 N.D. Cent. Code § 23-07-17.1 (3) 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.

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.

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 North Dakota

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___

The above AFFIDAVIT is available in Microsoft Word (.doc) and WordPerfect (.wpd) format.
Click here to Contact Donna.

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:

For employment situations, you may use the above AFFIDAVIT, and take out the N.D. Cent. Code § 23-07-17.1 (3), since that code applies only to school exemptions.

You could add this below to the AFFIDAVIT as your basis for refusal.

I believe we are totally responsible for our own health and bodies. I am very appreciative of the fact the US gives us freedom of choice in worship - immunizations and more. This does not mean that we do nothing - it means we use alternative methods to maintain health. Unlike medical remedies, which have detrimental side-effects, mega-nutritional support poses no such threat.

I consider so-called "immunization" which is mandatory to be an unreasonable bodily seizure, from which we are protected under the Bill of Rights, by the fourth amendment to the Constitution.

_____________________________

FOURTH AMENDMENT [U.S. Constitution] - 'The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.'

Unreasonable Searches And Seizures. Non-consensual extraction of blood implicates Fourth Amendment privacy rights. Skinner v. Railway Labor Executives' Ass'n, 489 U.S. 602, 16 ('89) ('this physical intrusion, penetrating beneath the skin, infringes [a reasonable] expectation of privacy'); Schmerber v. California, 384 U.S. 757, 67 ('66) (compulsory blood test 'plainly involves the broadly conceived reach of a search and seizure under the Fourth Amendment').' '[f]or the Fourth Amendment does not proscribe all searches and seizures, but only those that are unreasonable.' Skinner, 489 U.S. at 619; accord Vernonia School Dist. 47J v. Acton, No. 95-590, 1995 WL 373274, at *3 (June 26,'95) ('the ultimate measure of the constitutionality of a governmental search is `reasonableness''). A search's reasonableness under the Fourth Amendment generally depends on whether the search was made pursuant to a warrant issued upon probable cause. U.S. v. Place, 462 U.S. 696, 701 ('83)

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

Alternative Health:

Something you should know...
Did you know that LAETRILE can be legally used in North Dakota?
ND CENT CODE CHAPTER 23-23.1 LAETRILE
(.pdf) http://www.legis.nd.gov/cencode/t23c231.pdf

TB Test: Required only for international students. All others are exempt automatically.

TB Testing Exemption Letter:
HTML
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.htm
Microsoft Word Document (.doc)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBwaiverGen.doc

TB Testing Exemption Letter for Adults:
Microsoft Word Document (.doc)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBTestingWaiverAdult.doc
WordPerfect Document (.wpd)
Sample Exemption Letter for TB testing. May be modified to your use. http://www.vaclib.org/letters/TBTestingWaiverAdult.wpd
PDF document (.pdf)
Sample Exemption Letter for TB testing. http://www.vaclib.org/letters/TBTestingWaiverAdult.pdf

Extra link from Dr. Sheri Tenpenny's webpage:
(.pdf) http://drtenpenny.com/Documents/Exemption_for_TB_testing_1_.pdf

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
Microsoft Word Document (.doc)
Sample Exemption Letter for Lead testing. May be modified to your use. http://www.vaclib.org/letters/Lead_testing_waiverGen.doc

The above TB and Lead exemption letters courtesy of Deirdre DeVane of Wash DC. Thank you Deirdre!
The adult TB letters were edited by Sherri Tenpenny. Thank you Sherri!

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.

North Dakota BEST™ BioMeridian Practitioners:

Please call contact below to find 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

North Dakota QXCI Practitioners:

http://www.theqxci.com/information.php

Web Archive Link

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.

Information on this page is provided and sponsored by:
eWater.com!

eWater.com!

Vaccination Liberation - Idaho Chapter
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