Texas Immunization Exemption Affidavit: Request, Notarize, File

To claim a nonmedical exemption from required school shots in Texas, you file a Texas immunization exemption affidavit from the Department of State Health Services (DSHS). Since September 1, 2025, you can download a blank copy directly from the DSHS website, fill it in, have it notarized, and deliver it to the school or child-care facility. The exemption then covers your child for two years from the notarization date.¹

Getting the Blank Form

The quickest route is the DSHS immunizations page. The affidavit is posted as a printable file, and you don’t have to enter any personal information to access it. DSHS is prohibited from tracking who downloads or accesses the form.¹

If you want a paper copy mailed to you, DSHS still handles those requests. Delivery takes about three weeks. You can request forms through any of these channels:²

Online at co-request.dshs.texas.gov
Mail: DSHS Immunization Section, Mail Code 1946, P.O. Box 149347, Austin, TX 78714-9347
Fax: (512) 776-7544
In person: 1100 West 49th Street, Austin, TX 78756

Mailed and in-person requests need your name, complete USPS mailing address, telephone number, and the number of forms you need. You can request up to five forms per child or student.³ DSHS does not accept requests by phone or email.

Filling It Out

The affidavit is short. Enter the child’s full legal name and date of birth exactly as they appear in school records. A misspelled name or transposed digit gives a registrar a reason to reject the paperwork, so check against your child’s enrollment file first.

The pre-printed language on the form states that you decline vaccinations for reasons of conscience, which may include religious beliefs, and that you understand the benefits and risks of both immunization and going without it. You don’t have to list which vaccines you’re declining or describe your particular beliefs.¹

Do not sign the form at home. The notary has to watch you sign.

If the student is 18 or older, they sign for themselves instead of a parent or guardian.

Getting It Notarized

A notary public must witness your signature and apply an official seal for the affidavit to be valid.³ Bring a government-issued photo ID. Texas caps notary fees at $10 for the first signature on an acknowledgment and $10 for administering an oath or affirmation.⁴ Many banks, shipping stores, and public libraries offer notary services, sometimes at no charge for account holders. Confirm the notary’s commission is current, because an expired commission invalidates the notarization.

The date the notary stamps on the form starts the two-year clock.

Submitting It to the School

Give the completed, notarized affidavit to the registrar at your child’s school or the administrator at the child-care facility. Hand delivery or mail both work, and the school should place the original in your child’s records.

There is no separate deadline between notarization and submission, but the two-year validity period runs from the notarization date, not the day the school receives it. Submitting promptly preserves the useful life of the exemption. If the notarization is more than two years old when the school reviews it, the affidavit is expired and you have to start over.⁵

If Your Form Hasn’t Arrived Yet

A child whose affidavit is still in transit can be provisionally enrolled for up to 30 days under 25 TAC §97.66 and §97.69.² If the 30 days pass with no completed affidavit on file, the school can remove the child from classes until the paperwork arrives.

Renewing Before the Two Years Are Up

The affidavit is valid for exactly two years from the notarization date, and there is no automatic renewal.³ When expiration approaches, download or request a new blank form, complete and notarize it, and deliver the fresh copy to the school. A child whose exemption lapses can be excluded from attendance until a new affidavit or proof of immunization is on file.

Because the clock starts at notarization rather than submission, the practical window is slightly shorter than 24 months. Getting the new form notarized and submitted a few weeks before the old one expires prevents a gap.

What the Affidavit Does Not Cover

Outbreaks

Even with a valid exemption on file, an unvaccinated child can be temporarily kept out of school when the Commissioner of the Department of State Health Services declares an emergency or epidemic, under 25 TAC §97.62.³ The exclusion lasts until health officials determine the risk has passed. During measles outbreaks, state guidance has called for excluding unvaccinated students for up to 21 days after exposure.

Medical Reasons

The affidavit is only for conscience-based exemptions, including religious beliefs. A medical exemption uses a different process: a signed statement from an M.D. or D.O. licensed in any U.S. state who has examined the child and explains that the vaccine is medically contraindicated or poses a significant risk to the child or a household member. A medical exemption is valid for one year unless the physician notes a lifelong condition.³

College Meningitis Requirement

The conscience affidavit covers students in child-care facilities, elementary and secondary schools, and institutions of higher education, including those in health-related and veterinary courses.¹ Texas also requires incoming college students to show proof of a meningococcal vaccination, and exempting out of that requirement uses a separate DSHS form.⁶ If both apply, you complete two forms.

Privacy

DSHS is barred by statute from keeping any personally identifying information about individuals who download, access, request, or submit an affidavit form. The department may count total forms accessed or requested, but not who requested them.¹ Once the affidavit reaches the school, it becomes part of your child’s education records under FERPA and generally cannot be disclosed without your written consent, though school officials may share immunization status with public health authorities during a health or safety emergency.

1
State of Texas. Texas Health and Safety Code Section 161-0041 – Immunization Exemption Affidavit Form
2
Texas Department of State Health Services. Texas Immunization Exemptions
3
Legal Information Institute. 25 Tex. Admin. Code 97.62 – Exclusions from Compliance
4
Texas Secretary of State. Notary Public Educational Information
5
Texas Department of State Health Services. Affidavit Exemption From School or Child-Care Immunizations for Reasons of Conscience
6
Texas Department of State Health Services. Exemption from Meningococcal Vaccination Requirements