Medical and Religious Immunization Exemptions

  • Medical and religious exemptions are the only allowable exemption types. Philosophical objection is currently not allowed in NY State.


    Per NY public health law section 2164 and NYS health regulations - If a licensed physician, NP, (or licensed midwife caring for a pregnant student), certifies in writing that the student has a health condition which is a valid contraindication to receiving a specific vaccine, then a permanent or temporary (for resolvable conditions such as pregnancy) exemption may be granted.

    This statement must specify those immunizations which may be detrimental and the length of time they may be detrimental. Provisions need to be made to review records of temporarily exempted persons periodically to see if contraindications still exist. In the event of an outbreak, medically exempt individuals should be protected from exposure. This may include exclusion from classes or campus.

    - Medical exemptions MUST be renewed yearly
    - Exemption should state specific immunization and reason why
    - Exemption (doctor letter) should be submitted to the health office



    A student may be exempt from vaccination if, in the opinion of the school district, the student's parent/guardian (of those under 18 years old) or the student (if 18 years old or older) holds genuine and sincere religious beliefs which are contrary to the practice of immunization. The student requesting exemption may or may not be a member of an established religious organization.

    Requests for exemptions must be written and signed by the parent/guardian (if under 18) or the student (if over 18). The district may require supporting documents. It is not required that a religious exemption statement be notarized. In the event of an outbreak, religious exempt individuals should be protected from exposure. This may include exclusion from classes or campus.

    -Note that religious exemptions DO NOT transfer among school districts in NY state. If transferring in from another district, you MUST apply for a religious exemption with Gates Chili Central School District.


    Print, complete, and submit to the GCCSD Medical Director :

    Mail: Jacqueline Dennison, Medical Director, Gates Chili High School, 1 Spartan Way Rochester, NY 14624

    Fax: (585) 340-5545



    Request must be submitted within 2 weeks of student starting school, if a new student. Student may attend school until a decision has been made by the school district.


    Do NOT submit religious exemption request directly to school health office.

    Click Here >> Religious Exemption Form