Never sign a Refusal To Vaccinate if confronted by such a form.

The best way to avoid it, is avoid the allopaths
I always suggest a naturopath and/or chiropractor.
Here's the page that Dewey put up regarding that.
I have put a page up at:

With  two supporting forms at:
Here's the contents of the page below...
Do Not Sign
AAP or other self-incriminating Vaccine Refusal  forms
Basically, some doctors are giving patients who  chose not to vaccine their
children a form to sign created by the American  Academy of Pediatrics (AAP).
This form varies somewhat state to state but  basically it is a total
propaganda sheet about the alleged value of vaccines,  the alleged "risk"
of not
vaccinating and even worse the parent who signs the  form is falsely
that they are putting their children at risk. 
Lower on this page we have a letter from our director that explains more 
about why self-incriminating forms are to be avoided. 
When faced with a request to sign a form which removes liability from your 
doctor, you have several options:

    *   Change doctors to a holistic physician such as a naturopath,
homeopath or  other medical provider who does not require you remove the
from  their shoulders in the event your child becomes sick.
    *   Write your own form.
    *   Use our form 'as is' or modify it to reflect your  needs.
WARNING/DISCLAIMER: Please note that the law varies from state  to state.
Thus we HAVE NOT asked the advice of a lawyer about what unforeseen
might arise from using this form.
If you do consult a  lawyer in your state about using our form, please share
with us the comments  you receive. Thanks.
_RefuseVaccines1.doc  [MS Word 25K]_
_RefuseVaccines1.pdf  [Adobe PDF 87K]_
Note: the intention of this above form is as follows: 
    *   Give the doctor release from liability in case your child acquires
what  allegedly is a 'Vaccine Preventable Disease'. 
    *   Avoid the creation of liability for yourself. 
    *   Optional: Give the doctor a little bit of information to make  them
    *   Optional: Also put 'concerned parties' on notice that you have  done
your homework. 
    *   The form avoids telling the doctor why you chose not to vaccinate.
Your  reason for not vaccinating is your affair, unless you chose to
divulge it.
 For example, you might want the doctor to know that your religion forbids 
certain treatments.

    *   Re-write the given form and cross out key words which will change the
 document's meaning: I.E. "I am aware of the risks of not  vaccinating my
child. [cross out the word "not"]
Examples of a  re-written form: _Mod_ARvax2.doc_
(   |    _Mod_ARvax2.pdf_

Further  questions about exemptions: _
If  you need to email us about exemptions or exemption forms, _Click here:
The letter below is from our director, Ingri Cassel, and it explains why you 
should not sign any self-incriminating form.


Dear VacLib  Members and Friends - 
Wanted to give you all a heads up on state issued exemption forms. I haven't 
had to deal with this personally for several years, and I always crossed out 
sentences or clauses, and often adding some of my own, before signing their 
exemption of medical release type of forms. When Donna Carrillo began to 
diligently search out existing exemption forms and posting them, I read
over a 
couple of them and encouraged people to make up their own whenever  possible.
After having a "closer encounter" with such a form - a form  provided to the
state of Idaho by the American Academy of Pediatrics and the  Centers for
Control and Prevention and used by licensed Idaho daycares,  I was shocked
into the VERY REAL danger of signing these forms without changing  them

Any form one affixes their initials to, dates and affixes their signature to 
at the end is a LEGAL document. All statements prior to your signature you
must  agree to fully OR restrict your signature to say that you are signing
under TDC  - threat, duress, and coercion. The form that my daughter was
told she
needed to  fill out for this daycare is posted here:

 On this form,  she crossed out all
the "nots" and in her personal statement she further  clarified that she
understands fully the risks of vaccinating her child. 

I have since found out that most public schools and daycares in other states 
also use a similar form. Basically, by initialing and signing this form as
is,  you are admitting to understanding that "vaccine preventable" diseases
extremely deadly and ALSO admitting to negligence for willfully denying your 
son/daughter the life saving protection that vaccines offer. These forms are 
MEANT to not only be intimidating but to catch the legally ignorant off
guard.  This is very serious to me since all states have adopted the
funded  Child Abuse Prevention and Treatment Act which gives states the
right to 
literally steal your children for up to 48 hours -- the time they have to
prove  child neglect OR abuse. 

If it were ME, I would insist that they accept a form that I provide them 
since it satisfies the law. If there are any problems or they insist on me
 their form, I would cite the law and ask the school or daycare provider
where it  actually says in state statute that this particular form is the
form that  will satisfy the law. Since your parental rights are at stake
here, it
is best  to be vigilant and err on the side of being overly cautious.  
For more background on the problem of self-incriminating Vaccine Refusal 
forms see this offsite page: