Fill the immunization exemption's child and parent fields, fast

A non-medical immunization exemption for a school pupil uses a Statement of Conscience or Religious Belief, plus an education session and a witnessed signature. This guide is an example of letting hivi handle the repeating child and parent fields so the process is smoother.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Vaccines for children in schools — ontario.ca
• Form (Central Forms Repository): Statement of Conscience or Religious Belief — 014-4897-64

What this form is about

The statement records a non-medical exemption from vaccine requirements under the Immunization of School Pupils Act. It must follow the required process, including an education session and a witnessed signature.

Before you start: what to gather

• The child's name and details.
• The parent or guardian's details.
• Your Vaccine Education Certificate from the required education session.

The statement must be witnessed by a commissioner for taking affidavits. Confirm the current process on ontario.ca.

How hivi makes it faster

1. Store your family details once. Save the child and parent details in hivi.
2. Autofill the repeating fields. Use the hivi Chrome extension on a web form, or fill a PDF from your saved details inside hivi.
3. Complete the required steps. Finish the education session and have your signature witnessed.
4. Submit yourself to your local public health unit with your certificate.

Why do it in hivi

The child and parent details here also appear on school and health forms. Stored once in hivi — in Canada, with no third-party AI — the repeating fields fill themselves.