Parents or guardians need to request a vaccine exemption affidavit form in writing or via a secure online request form. Each child’s name and date of birth must be included in the request.

Mailing Address:
Immunization Branch
Department of State Health Services
Immunization Branch (MC 1946)
P.O. Box 149347
Austin, TX 78714-9347

Hand Delivery:
Department of State Health Services
Immunization Branch (MC 1946)
1100 West 49th Street
Austin, TX 78756

Fax:
512.458.7544

Hand-delivered requests may be submitted to the DSHS, Immunization Branch, between 8 a.m. and 5 p.m. Mondays through Fridays. ALL affidavit forms will be mailed to you via U.S. Postal Service. Important note: no requests will be filled at the time of hand-delivery.
Affidavit form requests will be processed and mailed within one week from the receipt of the request. If additional information is needed in order to process the affidavit, you will be notified.
The letter must include the following information:
- Full name of each child for whom a form is requested (first, middle, and last);
- Date of birth of each child for whom a form is requested;
- Parent or legal guardian’s signature and complete return mailing address, including zip code; and
- Number of forms needed for each child (not to exceed five forms per child)
Telephone requests cannot be processed.
The official Texas Department of State Health Services affidavit form must be notarized and submitted to school officials. The form must be submitted within 90 days from the date it is notarized.
In 2003, the Texas legislature passed changes to the statutes expanding the reasons a parent can claim an exemption. For everyone claiming an exemption for the first time after 9/1/2003, you must comply with the new law. If you have submitted an old religious exemption prior to 9/1/2003, you are grandfathered under the old law and do not need a new form. The vaccine exemption forms for reasons of conscience including a religious belief are only for students claiming a vaccine exemption for the first time after 9/1/2003 when the new law went into effect.
The school will accept only official affidavit forms developed and issued by the Texas Department of State Health Services (DSHS), Immunization Branch. No other forms or reproductions will be allowed.

Immunizations and Vaccines

Immunization Guidelines

Immunization Clinics

Exemptions to Immunization Requirements

Guidelines for Requesting an Exemption for Reasons of Conscience

Texas Immunization Requirements

More Information