Submit a Complaint

Do you believe your school has misinformed, misled, bullied, harassed, or discriminated against you regarding K-12 school exemptions? Please submit an online complaint to W.C.I.V. for our review and action.

Know the Law

DENIAL, HARASSMENT OF, or FAILURE TO INFORM parents of their RIGHT to reasons of conscience, religious, or medical vaccine exemptions in the state of Wisconsin is unethical. Rights to freedom of conscience/religion and informed consent are protected by the U.S. Constitution, and state law that specifically allows parents to decline any or all vaccines required for school by submitting a written statement.

Additionally, school websites and all written notices from school districts stating that certain vaccines are required or mandatory for school attendance, MUST also include information about all three exemptions (religious, personal, medical), otherwise they are OUT OF COMPLIANCE with Wisconsin state law (see WI Statute 252.04 below). Failure of schools to include information about all three exemptions, presents parents with incomplete and inaccurate information. We rely on the assistance of Wisconsin parents to help identify schools and districts out of compliance with state law and to request corrective action on your own or by submitting an online complaint (above).

WI Statute 252.04 (3) Immunization program
“The immunization requirement is waived if the student, if an adult, or the student’s parent, guardian, or legal custodian submits a written statement to the school, child care center, or nursery school objecting to the immunization for reasons of health, religion, or personal conviction. At the time any school, child care center, or nursery school notifies a student, parent, guardian, or legal custodian of the immunization requirements, it shall inform the person in writing of the person’s right to a waiver under this subsection”

Childcare and K-12 Exemption Forms

The Wisconsin DHS forms below, required by childcare facilities and K-12 institutions in Wisconsin, include checkboxes for religious, personal conviction and/or medical (signed by a physician) exemptions to vaccination.

Wisconsin Childcare Immunization Record with Waivers (PDF)
Wisconsin K-12 Immunization Record with Waivers (PDF)


This feature is for Members Only. Please login or join as a member to utilize this form.