This ridiculous, scaremongering, propaganda-filled vaccine refusal form is being handed out by pediatricians across the country. Besides assigning the child an ID # which will no doubt be added to a database somewhere, it literally asks parents to incriminate themselves for what sounds like child abuse and neglect by “admitting” on a signed form that they are knowingly endangering the life and health of their child (and others who might come in contact with their non-vaccinated child) by refusing vaccines.
Add this form to the list of things that should be refused in a pediatrician’s office.