STATEMENT OF RELIGIOUS EXEMPTION
The undersigned parent or legal guardian of___________, born on_________, states that this child is exempt from newborn screening testing for detection of congenital disorders in that the child is being reared as an adherent to a religion the teachings of which are opposed to such testing. ________________________________________________
(Signature of parent or legal guardian)
_____________________
(Date)
Or. Admin. Code § 333-024-0235
Stat. Auth.: ORS 431.180
Stats. Implemented: ORS 433.285