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Washington DOH 348-106: Certificate of Exemption

Washington uses this state form to exempt a child from school, child care or preschool vaccine requirements. Page one covers personal/philosophical and religious exemptions, which need a licensed practitioner's declaration that vaccine benefits and risks were discussed. Page two is the medical exemption, where the practitioner marks each disease as not exempt, permanently exempt, or temporarily exempt with an expiration date.

Who completes it

The parent or guardian signs every section used. A Washington-licensed MD, DO, ND, ARNP or PA signs the practitioner declaration on page one and completes and signs page two; the religious membership section needs no practitioner.

Submitting and payment

How to submit it
The COE must be printed from the DOH website; the family turns in the completed form to the school or child care.

Good to know

  • Measles, mumps and rubella cannot be exempted for personal or philosophical reasons; personal MMR exemptions on file before July 28, 2019 were voided.
  • The form states that the practitioner's signature on page one does not necessarily mean they endorse the decision; it confirms the benefits and risks discussion took place.
  • A practitioner may give a separate signed letter instead, attached to the parent-signed COE. Exemption certificates from other states are not accepted.
  • Only temporary medical exemptions expire; when one ends, the child may remain in conditional status for up to 30 days.

Get the official form

Download the current version from the source each time; forms change without notice.

Certificate of Exemption (COE)

Certificado de Exención

Official pagePDFVersión en español

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can sign the Washington Certificate of Exemption?

Only a health care practitioner licensed in Washington as an MD, DO, ND, ARNP or PA, who also writes their Washington license number. Parents sign their own declarations, and the religious membership exemption is the one section that needs no practitioner signature.

Does a Washington medical exemption need to be renewed every year?

No. DOH says the only Certificate of Exemption with an expiration date is one with a temporary medical exemption, and practitioners must enter the date it ends. Other exemptions do not need annual renewal, though a new COE version takes effect when DOH publishes it.