Medical Exemption Legal Consult – Frontline Health Advocates | Medical Exemptions for Vaccines and Masks

Name(Required)

Email(Required)

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Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Provide Other Parent’s Name And Contact Information

Parent’s name

Phone

Please provide the name of your child’s school/school district

Are you interested in becoming a plaintiff in a lawsuit against the state and/or school district?

Yes

Please provide the names and ages of each of your children

For each child, please list any previous vaccines they have received, how old they were when they received them and if the child had any adverse reactions to any particular vaccine.

Does your child(ren) have any underlying medical conditions that are contraindicated for receiving a vaccine?

Yes

If yes for underlying medical conditions, please provide details of the condition, when it was diagnosed, and the symptoms, complications, and/or treatments. If no, please write N/A.

Is family history of genetic issues listed as the reason for the current exemption request?

Yes

If yes, please provide the details of the genetic issues, which family members have those issues and what are the symptoms, complications, and/or issues with each. If no, please write N/A.

Do any of your children have an approved medical exemption that predates the most recent state law changes? If yes please provide a copy of the exemption.

Yes

Please describe any adverse reaction and for which vaccine. Describe which reactions, if any, presently persist and if a medical doctor has linked the adverse reactions to the vaccines?

Are both parents supportive of the lawsuit? Please explain the living-custody arrangement for the child/children being denied exemptions.

Are you aware if you child(ren)’s pediatrician was disciplined for providing any vaccine exemption?

Yes

Are you aware if your child(ren)’s pediatrician, who has been disciplined, is willing to participate in this litigation? If yes, please provide the name and contact information.

Please describe your experience with attempting to obtain a medical exemption for your child. Include the names and contact information for the doctors you contacted to obtain the exemption, when you contacted them, and what reasons if any they gave you for not extending a historic exemption or issuing a new one. Please also describe your interactions with your school district as well as the state health department.

What are your specific questions you have about moving forward?