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.
Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.163, eff. Sept. 1, 2003.
Amended by:
Acts 2013, 83rd Leg., R.S., Ch. 729 (S.B. 62), Sec. 2, eff. October 1, 2013.

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).

161.0001
Definitions
161.001
Liability of Person Who Orders or Administers Immunization
161.002
Inadmissibility of Immunization Survey Information
161.003
Immunization Reminder Notices
161.004
Statewide Immunization of Children
161.005
Immunizations Required
161.006
Department Immunization Service
161.007
Immunization Registry
161.008
Immunization Record
161.009
Penalties for Disclosure of Information
161.010
Immunization Education
161.011
Permission Required
161.012
Criminal Penalties
161.021
Authorization to Provide Information
161.022
Use and Publication Restrictions
161.023
No Liability for Reports to Medical Committee
161.024
Application to Health Maintenance Organization
161.031
Medical Committee Defined
161.032
Records and Proceedings Confidential
161.033
Immunity for Committee Members
161.041
Mandatory Reporting of Gunshot Wounds
161.0041
Immunization Exemption Affidavit Form
161.042
Mandatory Reporting of Controlled Substance Overdoses
161.043
Criminal Penalty
161.044
Controlled Substance Overdose Information Repository
161.045
Mandatory Reporting of Controlled Substance Overdoses for Public Safety Mapping
161.0051
Required Immunizations for Nursing Homes
161.0052
Immunization of Elderly Persons by Hospitals, End Stage Renal Disease Facilities, and Physicians’ Offices
161.061
Laboratory Information Required
161.062
Grounds for License Denial
161.071
Minimum Guidelines for Human Donor Milk Banks
161.0071
Notice of Receipt of Registry Data
161.0072
Providing Immunization Information to Department
161.0073
Registry Confidentiality
161.0074
Report to Legislature
161.0075
Immunity from Liability
161.0076
Compliance with Federal Law
161.081
Definitions
161.084
Warning Notice
161.085
Notification of Employees and Agents
161.086
Vendor Assisted Sales Required
161.087
Distribution of Cigarettes, E-cigarettes, or Tobacco Products
161.088
Enforcement
161.089
Preemption of Local Law
161.090
Reports of Violation
161.0095
Education Programs and Information
161.0101
Increase Immunization Awareness
161.101
Tests for Exposure to Lead
161.0102
Vaccines for Children Program
161.0104
Disaster Preparation
161.0105
Limitation on Liability
161.0106
Respiratory Syncytial Virus
161.0107
Electronic Medical Records Systems
161.0108
Injunction
161.0109
Human Papillomavirus
161.121
Definitions
161.122
Prohibition Relating to Certain Signs
161.123
Advertising Fee
161.125
Administrative Penalty
161.131
Definitions
161.132
Reports of Abuse and Neglect or of Illegal, Unprofessional, or Unethical Conduct
161.133
Inservice Training
161.134
Retaliation Against Employees Prohibited
161.135
Retaliation Against Nonemployees Prohibited
161.136
Brochure Relating to Sexual Exploitation
161.137
Penalties
161.201
Definition
161.202
Fees
161.203
Distribution of Records
161.204
Application of Other Law
161.0211
Epidemiologic or Toxicologic Investigations
161.0212
Right of Entry
161.0213
Confidentiality
161.251
Definitions
161.252
Possession, Purchase, Consumption, or Receipt of Cigarettes, E-cigarettes, or Tobacco Products by Minors Prohibited
161.253
E-cigarette and Tobacco Awareness Program
161.255
Expungement of Conviction
161.256
Jurisdiction of Courts
161.257
Application of Other Law
161.301
Tobacco and E-cigarette Use Public Awareness Campaign
161.302
Grant Program for Youth Groups
161.0315
Authority of Governing Body to Form Committee to Evaluate Medical and Health Care Services
161.351
Definitions
161.352
Report to Department
161.354
Public Information
161.355
Injunction
161.356
Compliance with Federal Law
161.401
Definitions
161.402
Material Safety Data Sheet Required
161.403
Injunction
161.404
Civil Penalty
161.405
Recovery of Costs
161.406
Administrative Penalty
161.407
Remedies Cumulative
161.451
Definitions
161.452
Requirements for Delivery Sales
161.453
Age Verification Requirement
161.454
Disclosure Requirements
161.456
Registration and Reporting Requirements
161.457
Collection of Taxes
161.458
General Offenses
161.459
Knowing Violation
161.460
Civil Penalty for Nonpayment of Tax
161.461
Forfeiture
161.462
Enforcement
161.471
Definitions
161.472
Formation of Kidney Sharing Pool and Distribution to Longest Waiting Patients
161.473
Discrimination on Basis of Disability Prohibited
161.501
Resource Pamphlet and Resource Guide Provided to Parents of Newborn Children
161.502
Duties of Department, Executive Commissioner, and Commission
161.503
Liability Not Created
161.551
Definitions
161.552
Directory of Services
161.601
Purpose
161.602
Definitions
161.603
Fee Imposed
161.604
Rate of Fee
161.605
Distributor’s Report and Payment of Monthly Fee
161.606
Report to Attorney General Before Offering Non-settling Manufacturer Cigarettes or Cigarette Tobacco Products for Sale or Distribution in This State
161.607
Penalties for Noncompliance
161.608
Appointment of Agent for Service of Process
161.609
Audit or Inspection
161.610
Comptroller Information Sharing
161.611
Revenue Deposited in General Revenue Fund
161.612
Released Claims
161.613
Application of Subchapter
161.614
Rules
161.651
Definitions
161.652
Information Regarding down Syndrome
161.653
Duty of Health Care Provider
161.681
Notice for Children Receiving Chemotherapy or Radiation
161.701
Definitions
161.702
Prohibited Provision of Gender Transitioning or Gender Reassignment Procedures and Treatments to Certain Children
161.703
Exceptions
161.704
Prohibited Use of Public Money
161.00705
Recording Administration of Immunization and Medication for Disasters and Emergencies
161.705
Prohibited State Health Plan Reimbursement
161.00706
First Responder Immunization Information
161.706
Attorney General Enforcement
161.00707
Information and Education for First Responders
161.00708
Access to First Responder Immunization History
161.00735
Release and Receipt of Registry Data in Disaster
161.0815
Nonapplicability
161.0825
Use of Certain Electronically Readable Information
161.0875
Sale of E-cigarette Nicotine Containers
161.0876
Prohibited E-cigarette Products
161.0901
Disciplinary Action Against Cigarette, E-cigarette, and Tobacco Product Retailers
161.0902
E-cigarette Report
161.0903
Use of Certain Revenue
161.01035
Provider Choice System

Accessed:
Jun. 5, 2024

§ 161.0041’s source at texas​.gov