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Oregon State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page |
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New Born Issues:Click for the desired information for your state Statues/Laws | NewBornBirthingPlan&BirthExemptions | Waivers_CareInSigning | Letters_Forms_Affidavits School-Daycare-Preschool Issues: Schools [all] | DayCare | Preschool | K-12 | College | (options)_OptOutRegistry | Adult Issues: Employment | TB_and/or_LeadTesting | Statues/Laws | Waivers_CareInSigning | Misc_Info, QXCI providers, Sponsors, etc. |
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Statues/Laws
Link 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 Submit a statement signed by the parent that the child has not been immunized as required because the child is being reared as an adherent to a religion the teachings of which are opposed to such immunization. |
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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. For details see: Newborn_Screening Steps:
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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... Information on the Dangers of Hospital Birth and the Benefits of Home Birth from gentlebirth.org 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)
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It would be good idea to use the AFFIDAVIT below AND a model birth plan letter from above.
Oregon Specific
Birth plan religious AFFIDAVIT text in Web page (HTML) here. Use with model birth plan letter and/or refusal forms, and edit as needed... AFFIDAVITs are also available in Microsoft Word HTML (simple text) Affidavit to modify. AFFIDAVIT in Microsoft Word Replace the paragraph (near bottom of page 1) of the generic AFFIDAVIT above with your state law as follows: [Make sure you replace with your name, status, and name of child.] (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, Oregon Revised Statutes 333-020-0165 (1), and 433.306 (2) to receive Religious Exemption from Vaccination, ALL injections, & testing. |
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Vitamin K Injection...[General information] ORS 433.306 - Oregon Revised Statutes (Vitamin K prophylaxis)... Sub Chapter: VITAMIN K FOR NEWBORNS Statute: ORS 433.306 Title: Duty to administer vitamin; religious objection; effect of inability to pay Text: (1) A physician licensed under ORS chapters 677, 684 and 685 or the midwife attending the mother at the birth of the child shall be responsible for insuring that the newborn infant shall receive vitamin K within 24 hours after birth by the most appropriate means, either by injection or orally. (2) The procedure described in subsection (1) of this section does not apply to any infant whose parents object to the procedure on the grounds that the procedure conflicts with the religious tenets and practices of the parents. The parents must sign a statement saying the infant is being so reared. (3) No infant shall be refused the procedure described in subsection (1) of this section because of the parents inability to pay. This proves to the hospital that religious exemption is allowed for Vitamin K refusal in Oregon. ORS 433.306 - Oregon Revised Statutes Vitamin K Injection...[General information] The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert. http://fdb.rxlist.com/drugs/drug-9003-Aqua-Mephyton+Inj.aspx?drugid=9003&drugname=Aqua-Mephyton+Inj "The injectable form of vitamin K can rarely cause severe (sometimes fatal) allergic reactions when given by injection into a muscle or vein. Therefore, vitamin K should be injected into a muscle or vein only when it cannot be given by injection under the skin or taken by mouth, or when your doctor has judged that the benefit is greater than the risk. Seek immediate medical attention if you experience symptoms of an allergic reaction such as rash, itching, swelling, dizziness, or trouble breathing."Potential exists for the newborn to experience hypersensitivity to any component of this medication. Each milliliter contains: Phytonadione ............. 2 mg or 10 mg Inactive ingredients: Polyoxyethylated fatty acid derivative ................... 70 mg Dextrose...................................................................... 37.5 mg Water for Injection, q.s. .................................................. 1 mL Added as preservative: Benzyl alcohol ...................... 0.9% Links to prescribing information for Vitamin K: http://vaclib.org/chapter/inserts.htm#vitK Archive: Year 2002 Merck Vitamin K Package Insert - Aquamephyton PI | posted on Scribd 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. |
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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 |
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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 |
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New Born Screening - Oregon IMPORTANT! Please download this if you're expecting a child or know someone who is! Northwest Regional Newborn Screening Program Oregon Practitioners's Manual A religious exemption can be claimed from the requirement for the newborn screening tests. In this event, the person otherwise responsible for submitting the specimen for testing is responsible for submitting a copy of the Informed Dissent form to the State Laboratory signed by the infants parent; see page 48. Parental Refusal In the event a parent refuses the testing, the program strongly urges practitioners to obtain an "Informed Dissent" signed by the parent and placed in the infants medical record. Suggested wording is provided on page 32 of NBS Manual Parental refusal (Informed Dissent form) page 32 of the pdf file. (.pdf)
http://public.health.oregon.gov/LaboratoryServices/This proves to the hospital that religious exemption is allowed for refusing newborn screening in Oregon. Should use with the Model Birth Plan letters. OREGON Sub Chapter: NEWBORN HEARING SCREENING TEST Statute: ORS 433.321 Title: Hearing screening tests for newborns; disclosure of information; exemptions (7) A hospital or birthing center directed to provide newborn hearing screening tests under this section is exempt from providing such services if the parent or guardian of the newborn child objects to the testing procedure on the grounds that the procedure conflicts with the religious tenets and practices of the parent or guardian. The parent or guardian must sign a statement that the newborn infant is being so reared. [Source: HB3246, 1999] Rule: 333-020-0130 (1) (c) No newborn child may be refused the Newborn Hearing Screening Testing because of an inability of the parent or guardian to pay for the testing. 333-020-0165(1) A hospital or birthing center directed to provide Newborn Hearing Screening Tests under these Administrative Rules is exempt from providing such services if the parent or guardian of the newborn child objects to the testing procedure on the grounds that the procedure conflicts with the religious tenets and practices of the parent or guardian. (2) The parent or guardian must sign a statement that the newborn child is being so reared, using the following language:
The undersigned parent (or guardian) of states that this child is exempt from testing for detection of hearing loss in that the child is being reared as an adherent to a religion the teachings of which are opposed to such testing. [ Source: Administrative Rule, Division 20, as of Stat. Auth.: 1999 Oregon Laws, Ch. 958Stat. Implemented: 1999 Oregon Laws, Ch. 958] This proves to the hospital that religious exemption is allowed for hearing screening refusal in Oregon. ORS 433.321 - Oregon Revised Statutes New Born Screening - general information 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 |
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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 |
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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 Short Sample Vaccine Letter 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. 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 |
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DayCare - Preschool - Schools - Colleges
DayCare-Preschool-K-12-CollegesDayCare | Preschool | K thru 12 | Colleges
DayCare See Oregon State Exemption Form, below
Preschool See Oregon State Exemption Form, below
Kindergarten & Schools See Oregon State Exemption Form, below Oregon Exemption Form
State Form:
Oregon's CIS form is preferred.Your school, preschool or daycare should have the Oregon CIS form. You can also print CIS forms online at http://public.health.oregon.gov/PreventionWellness/ . Make sure to print both pages so that required immunizations, recommended immunizations, and information about exemptions are all on the form. The CIS form has Medical Exemption info, Immunity Exemption info and a place on page 2 for the religious exemption. Another source of the Oregon CIS: (.pdf)
http://www.student.nbend.k12.or.us/Hillcrest/pdfdocs/State/immune_form.pdf Exemption - Page 2 It's the official Oregon CIS form, so will work for all Oregon schools.
State Report on the use of the religious exemption in Oregon Evaluation of Religious Exemptions to Oregon School Immunization ... http://public.health.oregon.gov/PreventionWellness/VaccinesImmunization/Documents/ReligExemptReport.pdf (.pdf)
http://www.tumbleweedinfanthouse.com/images/AllEnrollmentDocs.pdf Exemption - Page 2 These following religious exemption letters may be accepted in some schools or preschools. Oregon (School Children Religious exemption) (.doc) VaccineTruth.net/letters/Immunizations OR child (5186).doc
If you want a great letter written by a lawyer to an Oregon School Board Letter_Oregon_School_District.htm This letter was originally found at: http://www.childscreen.org/Letter%20to%20the%20Oregon%20School%20District.htm, but is no longer posted on this site so it has been moved to http://www.vaclib.org/pdf/letters/Letter_Oregon_School_District.htm
Colleges/Universities
Oregon Certificate of Immunization Status for Colleges & Universities Oregon Department of Human Services, Immunization Program Please note that this form has a check off box for the religious exemption If your college gives you a form that does not have the religious exemption check off box, then download this form. http://public.health.oregon.gov/PreventionWellness/VaccinesImmunization/GettingImmunized/Documents/CollegeCIS.pdf State law: http://www.leg.state.or.us/ors/433.html Southern Oregon University (.pdf) http://www.sou.edu/health/immunization_form.pdfExemption Section 1 Oregon Health & Science University School of Nursing Office of Student Affairs Hepatitis B Vaccine Waiver (.pdf)
hepBwaiver.pdf
Portland State University The Center for Student Health & Counseling (SHAC) Check Religious Exemption on page 2 (.pdf) http://www.pdx.edu.shac/files/media_assets/forms/mmrform.pdf
Check Religious Exemption box on Page 2. Portland State University's Intensive English Language Program (IELP) Measles (Rubeola) Vaccine Requirement (.pdf) http://oia.pdx.edu/images/isss/mmr4.pdfCheck Religious exemption box on page 2 Portland State University Here's the form for International Students: (.pdf) http://www.ielp.pdx.edu/pdf/IELP-Measles%20Forms%204-10.pdf
Check off box on page 2. Linfield College McMinnville, Oregon 97128 (.pdf) http://www.linfield.edu/assets/files/accounting/immunization.pdf 414 N. MERIDIAN ST. #6265 NEWBERG, OR 97132-2697 Measles Record Form 2004-05 (check exemption at the bottom of form) (.pdf) http://www.georgefox.edu/offices/hea_cou/measles_04-05.pdf EASTERN OREGON UNIVERSITY CERTIFICATE OF IMMUNIZATION At the bottom of the page is where you check off your exemption. I meet the following exemption(s) and thus do not need the measles immunization: (.pdf) http://www3.eou.edu/health/documents/mmrcertificateform.pdf (.pdf) http://www3.eou.edu/health/documents/MMRClearanceForm.pdf
An Adult Affidavit, with Christian beliefs, is here. (MSDOC file)
Feel free to modify as needed.
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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 Immunization Registry Opt-Out: IX. Voluntary Opt-Out In any circumstance in which a parent or guardian specifically request that information on their child be removed from ALERT, the child's record will be flagged so the parent or guardian will not receive reminders or recalls. However, under Oregon law, ALERT cannot remove the record or other information on any children from the registry. Such request from a parent or guardian must be in writing. |
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Employment
Suggestions for dealing with Employer Mandates.
Oregon (Adult Religious Exemption for employment) 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."See TB Testing 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.pdfClick here for an Affidavit for Adult (college & employment religious exemption) ... Edit as needed... |
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TB and/or Lead Testing TB-Links/Exemptions TB Test: Oregon State University - Only required for students from other countries NORTHWEST CHRISTIAN COLLEGE (targeted TB testing) 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. See QXCI-BioMeridian Providers, etc below |
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Misc Info - QXCI providers - Sponsors - Etc.
Global Quantum Quest; Worldwide EPFX Resource CentreGeneral link for QXCI practitioners in Canada, USA, Africa and The Netherlands. http://theqxci.com/practitioners.php Here are some of the practitioners for Oregon Oregon BEST BioMeridian Practitioners (Meridian Stress Assessment) World Wellness Dr. Christian Mathisen, D.C. Meridian Stress Assessment BIOMERIDIAN MSAS System 349 E. Main St. #3 Ashland, OR 97520 Phone: 541-552-1782 Fax: 541-552-1782 http://www.worldwellness.org beachavenue@jeffnet.org Meridian Stress Assessment provides a comprehensive, non-invasive method for evaluating a person's energetic balance and vital functions. Using ancient meridians and 21st Century computer technology, the MSAS allows a wide range of possibilities to help regain energetic balance. Dr. Christian Mathisen, D.C. uses the BIOMERIDIAN MSAS System. Liberty Massage and Wellness Center 795 Liberty St SE Salem OR 97301 Phone: (503) 371-7655 Fax: (503) 371-9070 Meridian Stress Assessment (MSA) http://www.libertymassage.com/page14.html http://www.libertymassage.com info@libertymassage.com Meridian Stress Assessment (MSA) 1 hour . . . . . . . . . . . . . . . . . . . . . . . $125 Holland Chiropractic and Rehabilitation Therapy 929 NW Grant Ave, Corvallis, OR 97330 Phone: 541.754.1023 | Fax: 541.758.0558 http://www.hollandchiroandrehab.com info@hollandchiroandrehab.com Meridian Stress Assessment Immune Function & Pathogenic Factors: This includes an in-depth analysis of the major areas of immune function, such as spleen, thymus, tonsillar tissues, and the lymphatic system. We also scan for signatures of viruses, bacteria, fungi, and parasites. Once we find the offending pathology, we create a program to clear this from the body. Cannon Beach Center for Natural Medicine Dr. Timothy Krupa, DC, Chiropractic Physician 183 N. Hemlock, Cannon Beach, Oregon 97110 Toll-free 1.888.577.8772 --or-- 503.436.8772 http://www.cbnaturalmedicine.com/allergies.html http://www.cbnaturalmedicine.com cbspa@pacifier.com The BEST Test, Biomeridian Electronic Stimulate Test Oregon QXCI Practitioners: Victoria Schnieder Certified Biofeedback, Bicom Certified, Loomis Enzyme Nutritionist Degree, EPFX / QXCI Practitioner Digestive Health Fees: $50.00 per hour 1st session (usually lasts 1 1/2 hours) Eugene, OR 541-343-7046 victoriacare@earthlink.net Susan Tyler Certified Biofeedback Therapist, Reiki Second Degree, SCIO Practitioner with specialties in Fibromyalgia, Detoxification, Anti-Aging and Immune Wellness Fees: $75 per session (lasts 90 minutes to 2 hours), $30 per hour of my time after that if needed All distance phone work -..no change there Oregon and USA for distance sessions, in person in Roseburg, OR area Distance Phone Sessions 541-496-2233 http://advancedbiofeedback.com www.orenda.iact1.com/11239 susan@advancedbiofeedback.com http://www.theqxci.com/practitioners.php#NorthWest Main page of practitioners: http://www.theqxci.com/information.php 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. |