To exempt a child from school or childcare immunizations in Florida, you need one of two official state forms. Form DH 680, the Florida Certification of Immunization, carries a medical exemption when signed by a licensed physician. Form DH 681 carries a religious exemption and is issued only by your local county health department. Picking the wrong form, or going to the wrong office to get it, is the most common reason families run into delays before the first day of school.
What Exemptions Florida Recognizes
Every child entering a public or private school from preschool through twelfth grade, or a childcare facility, must have a certification of immunization on file.1Florida Senate. Florida Code Title XLVIII 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases The state accepts three ways to meet the requirement without full immunization:
- A medical exemption, when a licensed physician certifies that one or more vaccines are medically harmful for the child. It can be permanent or temporary.
- A religious exemption, when a parent or guardian states in writing that immunization conflicts with their religious tenets or practices.
- A temporary 30-school-day exemption granted by a school official for homeless students, transfers, and youth in the juvenile justice system while records are located.2Cornell Law School. Florida Admin Code Ann R 64D-3.046 – Immunization Requirements: Public and Nonpublic Schools
Florida does not offer a philosophical or personal-belief exemption. If your objection is neither medical nor rooted in religious tenets, there is no current path to exemption in state law.
Medical Exemption: Form DH 680
The medical exemption is documented on Form DH 680, the same form used to record a child’s completed vaccinations. Your child’s pediatrician or the county health department usually already has blank copies.3Florida Department of Health. Child Immunizations A medical exemption applies only to the specific vaccines the physician identifies as contraindicated, not to the full schedule.
Permanent Medical Exemption
For a condition that permanently prevents vaccination, the physician completes Part C of Form DH 680. The doctor must list each specific vaccine being exempted and provide valid clinical reasoning or evidence for each one.4flrules.org. Florida Certification of Immunization DH 680 The signature must come from a physician licensed in Florida, or an authorized representative.2Cornell Law School. Florida Admin Code Ann R 64D-3.046 – Immunization Requirements: Public and Nonpublic Schools
Temporary Medical Exemption
If a child is working through a vaccine series or has a condition that temporarily prevents vaccination, the physician completes Part B. A temporary exemption is invalid without an expiration date showing when the required immunizations must be completed.4flrules.org. Florida Certification of Immunization DH 680 Once that date passes, the child needs either an updated form or completed vaccinations to stay enrolled.
Turning It In
Bring the original signed DH 680 to the school or childcare facility. The school official reviews it for validity and places it in the child’s file. A photocopy or fax does not substitute for the original.
Religious Exemption: Form DH 681
The religious exemption uses a different form, DH 681, and this is where families most often get tripped up. The form is not available at schools, pediatricians’ offices, or online. You must go in person to your local county health department to request it.5Florida Department of Health. Immunization Exemptions
What Happens at the Health Department
Ask for Form DH 681. You will sign it stating that immunization conflicts with your family’s religious tenets or practices. The county health department medical director, or a designee, must also sign the form before it is valid.2Cornell Law School. Florida Admin Code Ann R 64D-3.046 – Immunization Requirements: Public and Nonpublic Schools You do not need a letter from a religious leader or documentation of church membership. The Department of Health describes DH 681 as a form that is “issued” by the county health department on request.
Turning It In
Once you and the health department official have both signed, present the completed DH 681 to your child’s school or childcare facility before entry, attendance, or transfer.5Florida Department of Health. Immunization Exemptions The religious exemption form does not carry a printed expiration date. A single DH 681 covers all required immunizations at once.
Private Schools Must Accept the Same Forms
Florida’s immunization rules apply to both public and nonpublic schools, preschool through twelfth grade. The administrative code requires private school officials to accept the same DH 680 and DH 681 forms as public schools.2Cornell Law School. Florida Admin Code Ann R 64D-3.046 – Immunization Requirements: Public and Nonpublic Schools A private school cannot refuse a properly completed religious exemption that a public school would accept.
An Exemption Does Not Guarantee Attendance During an Outbreak
A valid exemption gets your child into school under normal conditions. It does not protect against exclusion during a communicable disease outbreak. The Florida Department of Health has the authority to exclude unimmunized students when a disease poses a direct risk, and the decision to exclude rests with the health department rather than the school district. During a measles outbreak at a Florida school in early 2024, that question became a point of public debate between health officials and the state government. Any exclusion lasts as long as the outbreak conditions warrant.
Homeless Students and Recent Transfers
Children experiencing homelessness, children in the child welfare system, and transfer students who arrive without records receive an automatic 30-school-day temporary exemption so they can enroll immediately while records are located or vaccinations arranged.1Florida Senate. Florida Code Title XLVIII 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases An authorized school official issues this exemption, not a doctor or the health department.
Cost
The DH 681 form is free at the county health department, and county health departments are required by law to provide the required immunizations themselves at no cost.1Florida Senate. Florida Code Title XLVIII 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases If you pursue a medical exemption through a private pediatrician, the office visit to review your child’s history and complete DH 680 is a separate charge that depends on the provider and your insurance.
Pending 2026 Changes to Watch
Senate Bill 1756, filed for the 2026 legislative session, would create a new conscience-based exemption category and change how a religious exemption form is obtained. The bill is still under committee review and has not become law.6Florida Senate. SB 1756 Health Policy Analysis The Department of Health’s immunization guidelines have not changed since 2013. If SB 1756 passes with the proposed July 1, 2026 effective date, the process described here could shift. Before filing an exemption for the coming school year, confirm the current requirements with your county health department.