Montana Religious Exemption Form HES 113
This document is the Montana Religious Exemption Statement Form HES 113 required for immunization exemptions for students in Montana schools. It allows parents or guardians to declare their religious objections to certain vaccinations. Use this form to provide the necessary information and declarations to your local health authority.
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How do I fill this out?
To fill out the Religious Exemption Form HES 113, begin by providing the student's personal information, including their full name, birth date, and the school they attend. Next, identify the specific vaccinations to which you are exempting the student based on your religious beliefs. Finally, ensure that the form is signed and dated by the parent or guardian.
How to fill out the Montana Religious Exemption Form HES 113?
1
Complete the student's full name and personal details.
2
Indicate the relevant immunizations against which you are claiming exemption.
3
Provide your contact information, including address and phone number.
4
Read and understand the implications regarding disease outbreaks.
5
Sign and date the form before submission.
Who needs the Montana Religious Exemption Form HES 113?
1
Parents seeking to exempt their child from immunization due to religious beliefs.
2
Guardians responsible for students who are not vaccinated.
3
School administrators who require documentation for enrollment.
4
Healthcare providers needing to understand vaccination exemptions.
5
Local health officials monitoring school immunization records.
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What are the instructions for submitting this form?
To submit the Religious Exemption Form HES 113, parents must ensure that the completed and signed form is delivered to the appropriate school office. You may also send it via fax to your local health department, which can be found on the health department's website. For quick online submissions, check if your school offers a digital submission platform.
What are the important dates for this form in 2024 and 2025?
For the Religious Exemption Statement Form HES 113 in 2024 and 2025, ensure timely submission before school enrollment deadlines. Generally, parents are advised to complete all necessary forms at least one month prior to the start of the school year. Check with Montana schools for specific cutoff dates regarding immunization documentation.
What is the purpose of this form?
The purpose of the Religious Exemption Statement Form HES 113 is to formally declare a student's exemption from certain vaccinations due to religious beliefs. This document provides parents or guardians the means to communicate their rights under Montana law regarding immunizations. It also helps schools and health officials maintain accurate records regarding vaccination compliance.
Tell me about this form and its components and fields line-by-line.
- 1. Student's Full Name: The complete name of the student requesting the religious exemption.
- 2. Birth Date: The date of birth of the student.
- 3. Age: The current age of the student.
- 4. Sex: The gender of the student.
- 5. School: The name of the school the student is attending.
- 6. Parent/Guardian Name: The name of the parent or guardian responsible for the student.
- 7. Address and City: The residential address of the student.
- 8. Telephone: Contact number for communication.
- 9. Vaccinations Exempted: List of vaccinations against which the student is claiming exemption.
- 10. Signature: Signature of the parent or guardian affirming the statement.
- 11. Date: The date when the form is signed.
What happens if I fail to submit this form?
Failure to submit the Religious Exemption Statement Form HES 113 may lead to the student's exclusion from school during outbreaks of vaccine-preventable diseases. Schools are required to keep accurate records of immunization status, and non-compliance with this form can jeopardize the student's enrollment. Parents should ensure timely submission to prevent any interruptions in the student's education.
- Exclusion From School: Without submitting the form, the student may be excluded during disease outbreaks.
- Immunization Records: Schools may have incomplete immunization records affecting enrollment.
- Legal Compliance: Non-compliance with state immunization laws can lead to penalties.
How do I know when to use this form?
- 1. School Enrollment: Required for enrollment where immunizations are mandated.
- 2. Immunization Compliance: Needed for compliance with school health regulations.
- 3. Religious Reasons: To formally articulate religious objections to vaccinations.
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