S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3860
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 30, 2025
                                ___________
 
 Introduced by M. of A. WILLIAMS -- read once and referred to the Commit-
   tee on Education
 
 AN  ACT  to  amend the education 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. The education law is amended by adding a new section 3205-b
 to read as follows:
   §  3205-B.  MEDICAL  IMMUNIZATION  EXEMPTION. 1. THE SCHOOL IN WHICH A
 STUDENT IS ATTENDING OR WILL ATTEND SHALL ACCEPT A MEDICAL  IMMUNIZATION
 EXEMPTION  REQUEST  FORM CONTAINING THE INFORMATION PURSUANT TO SUBDIVI-
 SION TWO OF THIS SECTION.   THE DEPARTMENT OR ANY  OTHER  STATE  AGENCY,
 BOARD OR COMMISSION SHALL NOT REQUIRE ANY OTHER CONDITION OR REQUIREMENT
 FOR  THE MEDICAL EXEMPTION TO IMMUNIZATION OR IMMUNIZATIONS PROVIDED FOR
 IN THIS SECTION FOR SCHOOL ADMISSION.
   2. THE FORM ACCEPTED BY THE SCHOOL SHALL CONTAIN THE FOLLOWING  INFOR-
 MATION:
   (A) NAME(S) OF PARENT, PARENTS OR GUARDIAN;
   (B) NAME OF CHILD;
   (C) STUDENT'S BIRTHDATE;
   (D) STUDENT'S RESIDENTIAL ADDRESS;
   (E) SCHOOL NAME AND DISTRICT;
   (F)  THE  MEDICAL  REASON,  DIAGNOSIS  AND/OR CONDITION OF WHICH DEEMS
 IMMUNIZATION DETRIMENTAL TO THE STUDENT'S HEALTH; AND
   (G) THE SIGNATURE OF A LICENSED PHYSICIAN,  PHYSICIAN'S  ASSISTANT  OR
 NURSE  PRACTITIONER,  THEIR  MEDICAL  LICENSE NUMBER AND PRACTICE AFFIL-
 IATION DECLARING: I HEREBY CERTIFY THAT IMMUNIZATION AGAINST (POLIOMYEL-
 ITIS,  MUMPS,  MEASLES,  DIPTHERIA,  RUBELLA,   VARICELLA,   HAEMOPHILUS
 INFLUENZAE  TYPE  B  (HIB),  PERTUSSIS,  TETANUS,  PNEUMOCOCCAL DISEASE,
 INFLUENZA, MENINGOCOCCAL DISEASE AND HEPATITIS B) MAY BE DETRIMENTAL  TO
 THE CHILD'S HEALTH. THE DATE AND SIGNATURE OF THE PHYSICIAN, NURSE PRAC-

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02758-01-5
              

 A. 3860                             2
 
 TITIONER OR PHYSICIAN'S ASSISTANT SHALL APPEAR HERE. THIS CERTIFICATION,
 ONCE  PROVIDED  TO  THE STUDENT'S SCHOOL, SHALL SERVE AS AN EXEMPTION TO
 SECTION 2164 OF THE PUBLIC HEALTH LAW.
   §  2.  This  act shall take effect on the thirtieth day after it shall
 have become a law.