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The conscience exemption affidavit must be requested in writing from the <a rel="noopener noreferrer" href="https://www.dshs.texas.gov/immunize/school/exemptions.aspx#conscience" class="Hyperlink SCXW15193560 BCX0" target="_blank">Texas Department of State Health Services</a>. After being notarized, the original form must be submitted by mail. The affidavit may NOT be submitted online. Mailing address below.&nbsp;<span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335551550&quot;:0,&quot;335551620&quot;:0,&quot;335557856&quot;:16777215,&quot;335559685&quot;:720,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:0}" class="EOP SCXW15193560 BCX0">&nbsp;
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Texas State Admissions<span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335551550&quot;:0,&quot;335551620&quot;:0,&quot;335559685&quot;:3873,&quot;335559737&quot;:0,&quot;335559738&quot;:109,&quot;335559739&quot;:0}" class="EOP SCXW15193560 BCX0">&nbsp;
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J.C. Kellam 680 I 601 University Drive I San Marcos, Texas 78666-46841 <span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335551550&quot;:0,&quot;335551620&quot;:0,&quot;335559685&quot;:481,&quot;335559737&quot;:0,&quot;335559738&quot;:37,&quot;335559739&quot;:0}" class="EOP SCXW15193560 BCX0">&nbsp;
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Phone 512.245.89781<span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335551550&quot;:0,&quot;335551620&quot;:0,&quot;335559685&quot;:481,&quot;335559737&quot;:0,&quot;335559738&quot;:37,&quot;335559739&quot;:0}" class="EOP SCXW15193560 BCX0">&nbsp;
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The conscience exemption affidavit must be requested in writing from the . After being notarized, the original form must be submitted by mail. The affidavit may NOT be submitted online. Mailing address below.  

Texas State Admissions 

J.C. Kellam 680 I 601 University Drive I San Marcos, Texas 78666-46841  

Phone 512.245.89781 

 

Texas State Conscientious Exemption

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 UW – Illegible

UW – MyChart Screenshot No Name

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Conscience Exemption

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UW - Needs 1 Mumps (MMR Under 1)

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UH-TB Confirmation By US Practitioner

Medical Exemption Request

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DEXT3

DEXT1

TB Outside of the US Not Accepted

NEIU- TDAP Expired

Not Required, Age Exempt- 22 Or Older

Missing Date Polio #1

Missing Date Polio #2

Missing Date Polio #3

Missing date Polio #4

Missing ULV TB Screening Form

Missing ULV Health History Form

Contact ULV Health Center

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UW HSIP - Required Hepatitis B

UW HSIP - Required TB Risk Assessment 

UW HSIP - Required MMR

UW HSIP - Required Varicella  

UW HSIP - Required Tdap  

UW HSIP - Required Tuberculosis Screen

UW HSIP - Required Influenza Vaccine  

UW HSIP - Required COVID-19 Vaccine

UW HSIP- Rejected Document Type  

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UW HSIP- Rejected MMR Negative Titer(s) 

UW HSIP- Rejected MMR Invalid Age Dose 

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UW HSIP- Rejected HepB Dose #3 Invalid 

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UW HSIP-Rejected TB Risk Assessment Form

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UW HSIP- Rejected Flu Vaccine Outdated 

UW HSIP- Rejected CV-19 Vaccine Outdated 

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