Statement of Conscience or Religious Belief (Vaccine Exemption Request)

In Ontario, a parent or guardian must complete a Statement of Conscience or Religious Belief form for children (Form 014-4897-64E) for their child to be exempt from vaccination requirements under the Immunization of School Pupils Act. This form must be witnessed by a notary public or commissioner for taking affidavits to obtain the non-medical vaccine exemption.

This form is sometimes simply called the “children’s vaccine exemption letter” or affidavit. For more information or to download the form, visit the Government of Ontario website.

Start your draft Book an appointment