S T A T E O F N E W Y O R K
________________________________________________________________________
1153
2025-2026 Regular Sessions
I N A S S E M B L Y
January 9, 2025
___________
Introduced by M. of A. SANTABARBARA -- read once and referred to the
Committee on Health
AN ACT to amend the public health law, in relation to a standardized
form for medical exemption from required immunizations
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subdivision 8 of section 2164 of the public health law, as
amended by chapter 401 of the laws of 2015, is amended to read as
follows:
8. THE COMMISSIONER SHALL DEVELOP A STANDARDIZED MEDICAL IMMUNIZATION
EXEMPTION REQUEST FORM FOR SCHOOL USE. If any physician, NURSE PRACTI-
TIONER OR PHYSICIAN'S ASSISTANT licensed to practice medicine in this
state [certifies] COMPLETES THE REQUIRED EXEMPTION FORM STATING that
such immunization may be detrimental to a child's health, the require-
ments of this section shall be inapplicable until such immunization is
found no longer to be detrimental to the child's health BY THE CHILD'S
PHYSICIAN, NURSE PRACTITIONER OR PHYSICIAN'S ASSISTANT. THE DEPARTMENT
OR ANY OTHER STATE AGENCY, BOARD OR COMMISSION MAY NOT REQUIRE ANY OTHER
CONDITION OR REQUIREMENT FOR THE MEDICAL EXEMPTION TO IMMUNIZATION OR
IMMUNIZATIONS PROVIDED FOR IN THIS SECTION FOR SCHOOL ADMISSION.
§ 2. Subdivision 8-a of section 2164 of the public health law is
renumbered subdivision 8-b and a new subdivision 8-a is added to read as
follows:
8-A. ANY PHYSICIAN, NURSE PRACTITIONER OR PHYSICIAN'S ASSISTANT WHO
BELIEVES THAT SUCH IMMUNIZATION MAY BE DETRIMENTAL TO THE CHILD'S HEALTH
MUST COMPLETE AND FILE WITH THE CHILD'S SCHOOL THE MEDICAL IMMUNIZATION
EXEMPTION REQUEST FORM THAT MAY INCLUDE BUT NOT BE LIMITED TO THE
FOLLOWING INFORMATION:
MEDICAL IMMUNIZATION EXEMPTION REQUEST FORM
(A) NAME(S) OF PARENT, PARENTS OR GUARDIAN:
(B) NAME OF CHILD:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01170-01-5
A. 1153 2
(C) CHILD'S BIRTHDATE:
(D) CHILD'S HOME ADDRESS:
(E) MEDICAL REASON, DIAGNOSIS AND/OR CONDITION OF WHICH DEEMS IMMUNI-
ZATION DETRIMENTAL TO THE CHILD'S HEALTH WITH CORRESPONDING MEDICAL
DOCUMENTATION:
(F) I HEREBY CERTIFY THAT IMMUNIZATION AGAINST (POLIOMYELITIS, MUMPS,
MEASLES, DIPTHERIA, RUBELLA, VARICELLA, HAEMOPHILUS INFLUENZAE TYPE B
(HIB), PERTUSSIS, TETANUS, PNEUMOCOCCAL DISEASE, INFLUENZA, MENINGOCOC-
CAL DISEASE AND HEPATITIS B) MAY BE DETRIMENTAL TO THE CHILD'S HEALTH.
THE DATE AND SIGNATURE OF THE PHYSICIAN, NURSE PRACTITIONER OR PHYSI-
CIAN'S ASSISTANT SHALL APPEAR HERE. THIS CERTIFICATION, ONCE PROVIDED TO
THE CHILD'S SCHOOL, SHALL SERVE AS AN EXEMPTION TO SECTION 2164 OF THE
PUBLIC HEALTH LAW.
§ 3. This act shall take effect on the thirtieth day after it shall
have become a law.