Vaccine Exemption Form

Get medical immunization exemptions completed and reviewed quickly with this easy-to-use exemption form template.

Simplify your workflows

Vaccine exemptions are critical for children that may have adverse reactions to immunizations. But jumping through all the hoops to get an exemption can be a hassle for both parents and doctors. This vaccine exemption form can simplify the process by giving doctors an easy way to collect the information they need without having to fill out a bunch of paperwork.

Go paperless

Nothing is more frustrating than having to fill out forms with the same information over and over again. With Formstack, you can pre-populate form fields with data collected from previous forms. This means that if a parent fills out a patient history form for their child, all the info they submit can be populated in the immunization exemption form automatically.

Stay HIPAA compliant

When you switch to digital forms, meeting security standards is critical. Use Formstack's HIPAA compliant solution to safely collect, store, and export your patient data. Protecting your information is easy with advanced data encryption, user-level permissions, audit logging, and dedicated security maintenance.

Collect signatures anywhere

Trade out pens and clipboards for mobile devices. This immunization exemption form is mobile-friendly out of the box and can be completed and signed anywhere. Doctors can pull it up on their tablet during appointments to take notes, fill out key sections, and collect electronic signatures.

Create seamless approvals

For most vaccine medical exemptions, doctors are the final authority on whether the exemption is accepted. However, in some states, exemptions have to go through a review process. Use this vaccine exemption form to get exemptions reviewed quickly by setting up an approvals process that lets staff members approve or deny requests directly in their emails.

Using Formstack reduces failure when bringing in new patients. It increases efficiency and cuts down on data entry for both patients and staff.
Dr. Chris Bojrab
President of Indiana Health Group

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