The following recommendations are not intended to be legal advice.

Colorado Vaccine Exemption Law is straight forward: Submit your own statement of vaccine exemption.

There is no need to use an official form, but most schools are not aware that the law allows parents to write their own Statement of Exemption. The law requires that to be accepted.
Here’s what to write:

Submit your own Statement of Vaccine Exemption for your child with the following content:

  • Name of child, child’s age, name of school, what vaccines your child has been given or not given, that your child’s information is not to be sent to any other State agency per your FERPA rights, your signature and date.
  • Provide a copy of the April 12, 2017 Drs. Wolk and Anthes Letter [PDF] to the school with your Statement of Exemption.
  • Feel free to use the CHCA sample Statement of Exemption [PDF] which closely mirrors the Anthes/Wolk policy letter.
  • Submit your statements directly to the school office; record date and person you gave it to.


If you get pressure from your child’s school to complete the CDPHE online or downloaded form as a condition of school attendance, here’s what and what not to do:

  1. Do not complete the CDPHE online exemption form; otherwise you will be complicit in acknowledging an incomplete opinion of vaccine policy and forfeit your family’s right to privacy under the Family Educational Rights and Privacy Act (FERPA).
  2. Write your own personally written statement, complete non-medical statement of exemption (religious or personal belief) with the following:
    i. To whom_(name of Nurse or administrator), school name, name of child, address and
    ii. Write “under authority of C.R.S. 25-4-903.B I hereby declare that my child is exempt from which vaccines if not all based on my (Personal or Religious beliefs…choose one)
    iii. Sign and date your statement.
    iv. Submit to the school; keep a copy for your records.
  3. If you have a medical exemption from your child’s doctor, your doctor is not required to complete any specific form per the same Colorado Statute. The doctor or the doctor’s authorized representative writes the same information as in i through iii above.