Shd Form Cre 1 PDF Details

In Virginia, the Certificate of Religious Exemption, known as the SHD Cre 1 form, serves as a vital document for those whose religious beliefs prevent them from receiving standard immunizations typically required for school enrollment. Through this form, a parent, guardian, or student officially asserts that administration of immunizing agents conflicts with their religious tenets or practices. It's important to understand the implications tied to submitting this form. For instance, in the event of a vaccine-preventable disease outbreak or potential epidemic within the school, the State Health Commissioner retains the authority to exclude the exempted child from school to protect them until the threat subsides. This form requires not only the signature of the parent, guardian, or student but also a formal affirmation in the presence of a notary, reinforcing its legal significance. With the ever-present possibility of public health emergencies, this document underscores the balance between individual religious rights and community health safety measures. The form itself, last revised in October 2005, provides a strict format for declaration and requires detailed information including the name, birth date, and student ID number of the individual seeking exemption.

QuestionAnswer
Form NameShd Form Cre 1
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesvaccine exemption form virginia, form cre 1, va religious exemption, religious exemption form virginia

Form Preview Example

COMMONWEALTH OF VIRGINIA

CERTIFICATE OF RELIGIOUS EXEMPTION

Name ____________________________________ Birth Date ____________________

Student I.D. Number __________________________________

The administration of immunizing agents conflicts with the above named student's/my religious tenets or practices. I understand, that in the occurrence of an outbreak, potential epidemic or epidemic of a vaccine-preventable disease in my/my child's school, the State Health Commissioner may order my/my child's exclusion from school, for my/my child's own protection, until the danger has passed.

_______________________________________________ ___________________________

Signature of parent/guardian/student

Date

I hereby affirm that this affidavit was signed in my presence on

This _______________________ Day of __________________________, 20__________,

In the city/county of ______________________________, Commonwealth of Virginia

_____________________________________

Notary Signature

My commission expires __________________

Notary Public Seal

SHD FORM CRE-1; REV. 10/05

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virginia religious exemption form conclusion process described (stage 1)

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