Arizona Vaccine Exemption Forms
Arizona law (A.R.S. §15-873) requires up-to-date immunization records before a child can attend school — unless a completed exemption form is on file. Below are the official forms from the Arizona Department of Health Services (ADHS).
Personal Belief Exemption (K–12)
For parents who decline one or more vaccines based on personal beliefs. Must be signed and submitted to the school before attendance.
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Personal Belief Exemption — Spanish (K–12)
Formulario de Exención por Creencias Personales — Kindergarten a 12º Grado.
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Medical Exemption Statement
Must be signed by a licensed Arizona physician (MD, DO, NP, or PA) stating that one or more vaccines would endanger the child's health.
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Religious Belief Exemption (Child Care only)
For child care / preschool. Arizona's religious exemption applies to licensed child care; K-12 schools use the personal belief form above.
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Printable Exemption Checklist
Personal Belief
Use the Personal Belief Exemption form. You sign it — no doctor needed. For K–12 schools.
Also available in Spanish.
Medical
Use the Medical Exemption Statement. Must be signed by a licensed AZ physician (MD, DO, NP, or PA).
Religious
Use the Religious Belief Exemption — only for licensed child care / preschool programs. K–12 uses Personal Belief.
3-Step Filing Checklist
- Download & print the correct form above. Arizona schools require an original signature (not typed or digital).
- Sign in front of school staff (personal belief) or have your physician sign (medical). Both parents may need to sign depending on school policy.
- Submit to your school's health office before the first day of attendance. Keep a photocopy for your records.
Tip: Click "Print Checklist" to print only this section.
Lista de Verificación de Exención Imprimible
Creencias Personales
Use el formulario de Exención por Creencias Personales. Usted lo firma — no necesita médico. Para escuelas K–12.
También disponible en inglés.
Médica
Use la Declaración de Exención Médica. Debe ser firmada por un médico de Arizona (MD, DO, NP o PA).
Religiosa
Use la Exención por Creencias Religiosas — solo para programas de cuidado infantil / preescolar. K–12 usa Creencias Personales.
Lista de Verificación de 3 Pasos
- Descargue e imprima el formulario correcto de arriba. Las escuelas de Arizona requieren una firma original (no escrita o digital).
- Firme frente al personal de la escuela (creencias personales) o haga que su médico firme (médica). Ambos padres pueden necesitar firmar según la política de la escuela.
- Entregue en la oficina de salud de su escuela antes del primer día de clases. Guarde una fotocopia para sus registros.
Consejo: Haga clic en "Imprimir Lista" para imprimir solo esta sección.
How to file an exemption (3 steps)
- Download & complete the correct form above. Print it — Arizona schools require an original signature (not typed).
- Sign in front of the school (personal belief) or have your physician sign (medical). Both parents/guardians may need to sign depending on your school's policy.
- Submit to your school's health office before the first day of attendance. Keep a copy for your records. The exemption stays on file until your child changes schools.
Important to know
- During a vaccine-preventable disease outbreak, children with exemptions may be excluded from school by the local health department until the outbreak is over.
- You can decline some vaccines and still receive others — you only check the boxes for the vaccines you are exempting from.
- Forms are accepted statewide — public, charter, and private K-12 schools must accept the ADHS form.
Frequently Asked Questions
Source: Arizona Department of Health Services (azdhs.gov) and Arizona Revised Statutes §15-873. Forms are linked directly to the official ADHS PDFs and may be updated by the state without notice.