- PA Code § 23.84.
Exemption from immunization.
- Sample Moral Exemption Letter
- Sample Religious Exemption Letter
- Letter to Principals
- Sample Letters to Legislators
- Press Release
- Printable Handout Page 1
- Printable Handout Page 2
We do not recommend using the Official PA Exemption Form provided on the PA Department of Health's website because it requests more information about your choice than is required by law. A simple letter like the samples above is all that is required.