Tex.
Health & Safety Code Section 161.0041
Immunization Exemption Affidavit Form
(a)
A person claiming an exemption from a required immunization based on reasons of conscience, including a religious belief, under Section 161.004 (Statewide Immunization of Children) of this code, Section 38.001 (Immunization; Requirements; Exceptions), 51.9192 (Bacterial Meningitis Vaccination Required for Certain Students; Exceptions), or 51.933 (Immunization Requirements; Exception), Education Code, or Section 42.043 (Rules for Immunizations), Human Resources Code, must complete an affidavit on a form provided by the department stating the reason for the exemption. This subsection does not apply to a person claiming the exemption using the Internet-based process under Section 51.9192 (Bacterial Meningitis Vaccination Required for Certain Students; Exceptions)(d-3), Education Code.(b)
The affidavit must be signed by the person claiming the exemption or, if the person is a minor, the person’s parent, managing conservator, or guardian, and the affidavit must be notarized.(c)
A person claiming an exemption from a required immunization under this section may only obtain the affidavit form by submitting a written request for the affidavit form to the department.(d)
The department shall develop a blank affidavit form that contains a seal or other security device to prevent reproduction of the form. The affidavit form shall contain a statement indicating that the person or, if a minor, the person’s parent, managing conservator, or guardian understands the benefits and risks of immunizations and the benefits and risks of not being immunized.(e)
The department shall maintain a record of the total number of affidavit forms sent out each year and shall report that information to the legislature each year. The department may not maintain a record of the names of individuals who request an affidavit under this section.
Source:
Section 161.0041 — Immunization Exemption Affidavit Form, https://statutes.capitol.texas.gov/Docs/HS/htm/HS.161.htm#161.0041 (accessed Jun. 5, 2024).
