Oregon parents claiming a nonmedical (religious, philosophical or other) exemption from school or child care vaccines must first show they received vaccine education. This one-page certificate is the health care practitioner route: after reviewing vaccine benefits and risks with the parent, the practitioner marks the diseases discussed and signs. The parent then turns it in with the Certificate of Immunization Status.
An MD, DO, ND, NP or PA, or an RN working under the direction of an MD, DO, ND or NP, writes the parent's name, marks the diseases discussed, signs, checks their practitioner type and adds the clinic name. The parent adds the child's name and date of birth.
Download the current version from the source each time; forms change without notice.
Vaccine Education Certificate (Parents)
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The certificate lets the signer check MD, DO, ND, NP or PA, or an RN working under the direction of an MD, DO, ND or NP. The practitioner reviews the benefits and risks of immunization with the parent under rules adopted under ORS 433.273, then signs and dates it.
Yes. Parents can complete OHA's online Vaccine Education Module, offered in English, Spanish and Russian, and print the certificate at the end. They must save or print it before closing the module, because the certificate cannot be retrieved later.