Notaron does not provide legal or medical advice and is not affiliated with the Texas Department of State Health Services. The notary verifies your identity and signature, not the content of the affidavit.
Fill out and notarize your Texas vaccine exemption affidavit online
Texas requires the conscientious exemption affidavit to be notarized before your child's school or child-care center will accept it. Fill it out right here, save it as a PDF, then sign with a live notary over video — usually in under 10 minutes.
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The short version
- The affidavit must be notarized — an un-notarized one isn't valid.
- It's valid for two years from the date it's notarized, then you'll need a new one.
- One affidavit per child. It covers only the person named in section A.
- Online notarization is authorized in Texas, and you can sign from anywhere.
Fill it out right here
- Type the name and date of birth, and check the vaccines you're declining.
- We fill them in on the official DSHS form (F11-11755) and save it as a PDF.
- Your answers stay on your device. Nothing is uploaded unless you choose to notarize.
- More than one child? Add each one, then notarize them all in one session.
What goes in each section
DSHS doesn't accept an affidavit with changes or additions. If you're filling it in by hand and make a mistake, print a fresh copy rather than crossing it out.
(A) Individual's full name
The child's first, middle, and last name and date of birth (mm/dd/yyyy), exactly as the school has them. If you're an adult student, this is you.
(B) Vaccines you're declining
Check the box next to each vaccine you do not want given. Check only the ones that apply. The affidavit covers only the vaccines checked here.
(C) Benefits and risks acknowledgment
Nothing to fill in. By signing you confirm you've read the DSHS benefits and risks of vaccination information, and that the student can be kept out of school during a declared emergency or outbreak.
(D) Signature and date
Leave this blank. The parent or legal guardian (or the adult student) signs and dates it during the video session, with the notary watching.
State of Texas / County / Notary public
Leave the whole bottom block blank. The notary fills in the certificate and applies the seal.
A few rules that trip people up
- Changes or additions make it invalid. Don't cross out or add to the printed form.
- Give it to every school that needs it. Each Texas school or child-care facility the student attends needs a copy of the notarized affidavit.
- The signer joins the session. The parent or legal guardian who signs — or the adult student — is the one who shows ID and signs on video.
- Medical exemptions are different. They come from a physician (M.D. or D.O.), not this form.
From blank form to notarized in four steps
You'll need the affidavit, a government photo ID, and a phone or laptop with a camera.
Fill out sections A and B
Use the form on this page, or download the official DSHS affidavit (F11-11755) and print it. One affidavit per person.
Save it — don't sign yet
Save the PDF to your phone or computer. Leave the section D signature and the notary block blank.
Verify your identity
Upload the affidavit, scan a valid government-issued photo ID and answer a few identity questions.
Sign on video and download
Sign while the notary watches; the notary completes the certificate and applies their seal. Download the notarized PDF.
Most sessions take under 10 minutes. Notaries are available 24/7, with no appointment needed.
Want the state to mail you a blank affidavit?
Send DSHS the request form (EF11-13140) by mail or fax, or request one online. DSHS says mailed forms take about three weeks. When it arrives, fill it out the same way, then take a photo of it to upload. The request form itself doesn't get notarized.
Questions
Does the Texas exemption affidavit have to be notarized?
Can I fill it out online?
How long is the affidavit good for?
Should I sign it before the session?
I have more than one child. What do I do?
Will my school accept an online notarization?
Is this the same as a medical exemption?
Affidavit filled out? Let's notarize it.
Upload it, verify your ID, and sign with a commissioned notary on secure video 24/7 — from $25 per session.