Medical Reasons:
The Texas Department of State Health Services (DSHS) considers vaccines to be very safe and encourages all Texans to be vaccinated according to the ACIP recommended schedule. DSHS recognizes, however, that for a small number of people, there may be valid medical reasons for which they cannot receive certain vaccines. For school and childcare attendance, the state allows for medical exemptions to accommodate these individuals. Schools and childcare facilities should accept medical exemptions that are signed by a US-licensed MD or DO and clearly state a medical reason the person cannot receive specific vaccines. Unless the exemption states a lifelong condition, the exemption is only valid for one year.
Requesting an Exemption for Reasons of Conscience:
To claim an exclusion for reasons of conscience, including a religious belief, the child's parent, legal guardian, or a student 18 years of age or older must present to the school or child-care facility a completed, signed and notarized affidavit on a form provided by the department stating that the child's parent, legal guardian, or the student declines vaccinations for reasons of conscience, including because of the person's religious beliefs.
The form must be submitted to the school or child-care facility within 90 days from the date it is notarized. The affidavit will be valid for a two-year period from the date of notarization. A child or student who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of the department.
A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization may only obtain the affidavit form by submitting a request (via online form, mail, fax or hand-delivery) to the department. The request must include following information:
- Full name of child or student
- Child's or student's date of birth (month/day/year)
- Complete mailing address, including telephone number
- Number of requested affidavit forms (not to exceed 5).
View the Request for Exemption from Immunizations for Reasons of Conscience for written requests.
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.
Email or telephone requests cannot be processed. Requests for affidavit forms must be submitted to the department through one of the following methods:
Obtaining an Affidavit Online
Affidavits may be requested via the Immunization Unit Affidavit Request website.
It is recommended individuals use the Microsoft Edge web browser when submitting a vaccine exemption request online. The Google Chrome web browser may not function properly.
Obtaining an Affidavit By Mail
A written request for an affidavit may be sent through the United States Postal Service (or other commercial carrier) to:
Texas Department of State Health Services
Immunization Branch, Mail Code 1946
P.O. Box 149347
Austin, Texas 78714-9347
Obtaining an Affidavit By Fax
Fax written requests for affidavits to: (512) 776-7544.
Obtaining an Affidavit In Person
NOTE: No requests will be filled at the time of hand-delivery.
All affidavit forms will be mailed to you via U.S. Postal Service.
Requests for an affidavit may be made in-person at:
Texas Department of State Health Services
1100 West 49th Street
Austin, Texas 78756