How to Fill Out and Submit Iowa’s Religious Immunization Exemption Form

To claim a religious exemption from Iowa’s school and childcare immunization rules, you complete the state’s Religious Certificate of Immunization Exemption — a free, one-page form from the Iowa Department of Health and Human Services — and hand it to the admitting official at the school or childcare center where the student is enrolling. No notary is required. The Iowa religious immunization exemption form is available on the department’s Vaccines and Immunizations page and on the IRIS registry site, and the same form works for public, private, parochial, and postsecondary enrollment.

Who Qualifies

Iowa Code 139A.8 requires proof of immunization for every child entering a licensed childcare center or an elementary or secondary school, with a narrow religious exemption available when vaccination conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.¹

The signer must attest that the belief is “in fact religious and not based merely on philosophical, scientific, moral, personal, or medical opposition to immunizations.”² A general discomfort with vaccines or a preference based on personal research will not qualify.

For a minor, a parent, legal guardian, or legally authorized representative signs. Students who have reached the age of majority (18 in Iowa) or who are legally emancipated sign for themselves.³

Where to Get the Form

Download the “Religious Certificate of Immunization Exemption” from the Iowa Department of Health and Human Services Vaccines and Immunizations page at hhs.iowa.gov.⁴ The same PDF is hosted on the Iowa Immunization Registry Information System (IRIS).³ Many schools, childcare centers, and healthcare providers also keep blank copies on hand.

There is no fee. Use only the official version. The administrative code states that any edits or alterations to the language on the certificate will invalidate it, so do not cross out words, add conditions, or attach addendums.²

How to Fill It Out

The form is short, but every field matters. A certificate missing any of the required elements can be rejected at enrollment.²

Student’s last and first name, exactly as they appear in school enrollment records.
Student’s date of birth, so the certificate can be matched to the correct file.
Signature of the parent, guardian, authorized representative, or adult student, affirming the attestation already printed on the form.

The pre-printed attestation also acknowledges that the Iowa Department of Health and Human Services has published information about the risks of skipping vaccinations, including the danger to children with special health needs who cannot be vaccinated. Your signature confirms you are aware of those materials.³

You Do Not Need a Notary

Iowa used to require this certificate to be notarized. That requirement has been removed, and Iowa HHS has confirmed a notary signature is no longer needed.⁵ The current administrative code lists only the student’s name, date of birth, and the signer’s signature and attestation — no notary seal appears in the rule.²

Where to Submit It

Give the completed certificate to the admitting official at the school or licensed childcare center where the student is enrolling. The form itself directs the parent, guardian, or adult applicant to submit it directly to that official.³ A child cannot attend without an immunization certificate, an exemption certificate, or a provisional certificate on file by the first day of attendance.⁶

The admitting official keeps the certificate on file for as long as the student is enrolled at that location.⁷ There is no annual renewal. Once properly filed, the exemption stays active at that school or center.

When the Exemption Will Not Protect Attendance

Filing the form does not guarantee uninterrupted attendance. The certificate itself warns that a child with a religious exemption may be excluded from childcare or school during a disease outbreak, for anywhere from several days to over a month depending on the disease and circumstances.³

The administrative code goes further. During a declared emergency or epidemic, both medical and religious exemptions stop applying entirely, and the exemption on file does not shield the student from exclusion.² The local board of health or Iowa HHS sets the duration and scope of any exclusion.

College and University Students

Iowa’s immunization rules extend to institutions of higher education, including Board of Regents schools, community colleges established under Iowa Code chapter 260C, and accredited private institutions.⁸ The same religious exemption under Iowa Code 139A.8 applies.

Postsecondary students, typically 18 or older, sign the form themselves. The University of Iowa, for example, requires a current religious exemption form submitted to the student health office and will not accept a certificate from childhood.⁹ Check with your campus student health office for its submission method, since some accept email or an online portal and others require an in-person drop-off.

1
Iowa Legislature. Iowa Code 139A.8 – Immunization of Children
2
Legal Information Institute. Iowa Admin Code r 641-7.3 – Persons Excluded
3
Iowa Department of Health and Human Services. Religious Certificate of Immunization Exemption
4
Iowa Department of Health and Human Services. Vaccines and Immunizations
5
Iowa Department of Health and Human Services. Executive Order 10 – Chapter 7 Immunization Requirements
6
Iowa Department of Education. Student Health Requirements for Schools
7
Legal Information Institute. Iowa Code r 641-7.8 – Records and Reporting
8
Iowa Legislature. Iowa Administrative Code 641-7 – Immunization and Immunization Education
9
The University of Iowa. Immunization Exemptions