Arkansas parents who want a medical, religious or philosophical exemption from child care or school vaccine requirements must apply to the Department of Health every school year. For a medical exemption, the application must include a physician statement outlining the medical reasons for exempting each specific vaccine, and the Immunization Section's Medical Director decides whether to grant it.
The parent or guardian completes the application and signs it before a notary. The physician supplies a separate statement, typically a letter, explaining the medical reasons for each vaccine to be exempted.
Download the current version from the source each time; forms change without notice.
Childcare-School Immunization Exemption Application (with physician statement for medical exemptions)
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ADH's FAQ asks for a physician statement outlining the medical reasons for exempting a specific immunization, submitted to the Immunization Section's Medical Director with the exemption form. The Medical Director decides whether to grant the exemption based on CDC guidelines, so each vaccine and its reason should be clear.
Yes. An application with the notarized signature of the parent or guardian must be submitted to the Department of Health each school year, using the current year's packet. Outdated or alternate forms are not allowed, and incomplete forms are returned for completion.