Immunizations

To obtain a medical exemption, parents must have the 2nd page of the MDH Student Immunization Form filled out by the student's medical provider. Providers must mark which immunization the student has a medical exemption from under the medical exemption column in Part 1. The medical provider must also sign and date the form in Section A. 

• History of Chickenpox/Varicella Disease: Must have Part 2 on the 2nd page of the MDH Student Immunization Form filled out with month and year the student was diagnosed with Chickenpox. A parent/guardian may check the box and sign if the Chickenpox was on or before September 1st, 2010. If it was after September 1st, 2010, Part 2 of the form must be filled out and signed by the student's medical provider.

To obtain a non-medical exemption, parents must have the 2nd page of the MDH Student Immunization Form filled out by the parent/guardian and notarized. The parent/guardian must mark which immunization the student should be  exempt from under the non-medical exemption column in Part 1 in order for the form to be valid. The parent/guardian then must sign the form with a notary present and also obtain a signature from the notary.