Form Vph 28 PDF Details

When it comes to managing the health of pets, particularly with regard to vaccinations, owners often rely on guidance from both legal and health authorities. The VPH-28 form, issued by the New Jersey Department of Health and Senior Services, stands as a critical document for those rare but important instances where an animal cannot, for medical reasons, receive a rabies vaccination. This document, formally known as the Certificate of Exemption from Rabies Vaccination, requires detailed information including the owner's contact details, along with the animal's name, species, breed, age, and other identifying details. Upon examination, if a veterinarian concludes that vaccinating the animal could be harmful due to an existing condition, this form legally exempts the animal from the mandatory rabies vaccine for up to a year, under certain conditions. However, it's important to note that this exemption does not mean the animal can avoid all the responsibilities and precautions associated with rabies prevention. Owners are informed through this document of their obligations, including re-examination of the animal before the exemption expires, the heightened risks to their animal, and the legal implications if their pet exposes rabies to a human or another animal. The VPH-28 form thus serves as a vital tool for ensuring the well-being of pets who cannot be vaccinated, while still upholding public health standards regarding rabies control.

Form NameForm Vph 28
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesvph 28 100585 certificate of exemption from rabies vaccination michigan form

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New Jersey Department of Health and Senior Services


Name of Owner (Print)

Telephone Number

Street Address

Animal Name


City, State, Zip



















The animal described above has been examined by me on: ________________ and I have determined that it would be

medically contraindicated to vaccinate this animal due to an infirmity, other physical condition, or regimen of therapy.

Describe nature and duration of infirmity, other physical condition, or regimen of therapy:

PLEASE NOTE: A reluctance to administer a rabies vaccine prior to the expiration of the previous vaccination will not be accepted as a valid reason for an exemption. Early boostering has not been associated with an increased occurrence of adverse reactions and is not medically contraindicated.

Name of Veterinarian (Print)

License Number


Signature of Veterinarian


This certificate is valid until


(not to exceed one year from date signed).

By signing below, I acknowledge that I am the owner of the animal described above. I have been informed that this animal is exempt from rabies vaccination for a period of up to one year. I have also been informed of the following important information:

This animal must be re-examined by the expiration date listed above. At that time the animal must either be vaccinated against rabies or, if exemption status still applies, a new certificate must be issued.

Once the duration of immunity from the last rabies vaccination has lapsed, this animal is not protected against rabies and, as a result, is at increased risk of becoming infected if exposed to a rabid animal.

It is recommended that the animal be closely observed when outside, walked on a leash and not allowed to run at large. Prevent the animal from coming into contact with suspect rabid animals such as raccoons, skunks, foxes, groundhogs, bats and free-roaming cats.

Exemption from rabies vaccination does not exempt the animal from other laws related to rabies. If this animal is potentially exposed to rabies (e.g., due to a bite or exposure from a rabid or suspect rabid animal), the local health agency will require it to be euthanized or quarantined for six months. If this animal potentially exposes a person to rabies (by bite or other means), it must be confined for 10 days as approved by the local health agency where the animal resides.

Signature of Owner

Date Signed

A copy of this certificate must be provided to the owner of the animal listed above and kept as proof of exemption.

For dogs, this certificate must be presented with an application for a dog license.

VPH-28 APR 07