Ga Vaccine Exemption – Fill Out and Use This PDF

Updated: Nov 9, 2026

The Georgia Vaccine Exemption form is a legal document that allows parents or guardians to exempt their child from vaccination requirements based on religious beliefs, in accordance with the Official Code of Georgia Annotated § 20-2-771 4.(e). It requires an affidavit from the parent or guardian asserting that vaccination conflicts with their religious beliefs. This form plays a critical role in respecting individual rights while balancing public health concerns. To learn more about how to properly fill out and submit this form, click the button below.

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Ga Vaccine Exemption PDF Details

In Georgia, parents or guardians have the right to exempt their child from vaccinations due to religious beliefs, as outlined in the state's Official Code. This exemption, spelled out under § 20-2-771 4.(e), stipulates that immunizations, typically mandated for school enrollment, can be waived if they conflict with the family's religious convictions. To utilize this exemption, a detailed affidavit must be submitted to the respective educational institution or group program, affirming that the required immunizations contravene the religious beliefs of the parent or guardian. The form itself is a declaration by the parent or guardian, clearly opposing the administration of vaccines to their child, listing various diseases for which vaccination can be refused. This legal document must be acknowledged before a notary to-complete its validity. Additionally, the form accompanies a message urging parents to make an informed decision regarding vaccinations, highlighting potential risks and adverse reactions associated with vaccines, and questioning their efficacy and safety. It encourages parents to thoroughly research vaccines, consider the health history of their children before vaccination, and educate themselves on alternative disease management strategies. Providing resources for further information and advising on the reporting of vaccine reactions, the document underscores the importance of parental responsibility in the decision-making process about their child's health and vaccination status. This approach underscores the balance between public health mandates and individual religious freedoms in Georgia’s legislative framework.

Question	Answer
Form Name	Ga Vaccine Exemption
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	religious exemption georgia, georgia religious exemption, dph form 2208, ga vaccine

How to Fill Out Vaccine Exemption Form

Vaccine Exemption Form at a glance

What it is: On the Vaccine Exemption Form, a parent, guardian or person in loco parentis certifies that the administration of any vaccine or other immunizing agents is contrary to religious beliefs.

Notary: Notary: Subscribed and Sworn before me this day of, 20, with the Notary's Signature and Seal.

For a child to be exempt from immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian.

This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages.

A filled-in Vaccine Exemption Form example: two parents certify for one child

Vaccine Exemption Form example filled out, example: two parents certify for one child — Jane and John Sample complete the Vaccine Exemption Form for their child. Both parents sign on March 14, 2026, before a notary public, who completes the notary lines. Other is left blank because no vaccine beyond the twelve listed is named. The picture shows page 1, and all its values are invented.

How to fill out Vaccine Exemption Form, box by box

Your name and your child's name

Insert your name after I, as the parent, guardian or person in loco parentis of the child, then insert your child's name.

The vaccines listed

The form lists Diphtheria, Measles, Other, Tetanus, Mumps, Pertussis, Rubella, Polio, Haemophilus influenzae type b, Hepatitis B, Varicella, Smallpox and Anthrax.

Parent lines and dates

The form has two Parent lines, each with a Date line.

Subscribed and Sworn before me

Notary: Subscribed and Sworn before me this day of, 20, with the Notary's Signature and Seal.

More rules for Vaccine Exemption Form

Pursuant to Georgia statute, you are providing a copy of this statement to your child's school administrator or operator of the group program pursuant to O.C.G.A. § 20-2-771 (4e).

Sources

[1] Vaccine Exemption Form, Georgia (O.C.G.A. § 20-2-771), served file (the Official source link on this page).