DOCTORS WHO (MAY) SIGN VACCINE EXEMPTIONS

SYRINGE1

elyse serious

Tara Zandvliet MD
Address: 2991 Kalmia St, San Diego, CA 92104
Phone: (619) 929-0032

Kelly Sutton, MD
Sacramento, CA

Dr. Donald S. Adema, DO
10201 Mission Gorge Rd Ste C
Santee, CA 92071
(619)596-5445

Kenneth Stoller, MD
Hollywood, CA

Pak Chan, MD
Lockeford Medical
209 727 5523

Dr Iman Bar
Orange County
949 646 3623

Dr Susan Cocke
Yorba Linda

Richard Hiltner MD
805 647 1495

Dr Thomas Cowan, MD
Four Fold Healing
661 Chenery St, San Francisco, CA 94131
(415) 334-1010

James Gerard Brewer, M.D.
2421 Bath Street, Suite A
Santa Barbara, CA 93105
(805) 563-0167

Mylene Rucker MD
559 635 1746
Visalia, CA

Dr. Jay Gordon
901 Montana Ave
Santa Monica, CA 90403
(310) 393-9784

Pejman Katiraei
Loma Linda University Pediatric Wholistic Medicine Clinic
11370 Anderson Street, B100
Loma Linda, CA 92354
(909) 558-2828
pkatiraei@llu.edu

Dr. Jody Lappin
901 Montana Ave.
Santa Monica, CA 90403
(310) 393-9784

Amber Weiss, PA
Santa Cruz CA
831-824-4005

Dr. Marcus Porrino
Dr. Rebecca H. Porrino
Sonoma Naturopathic Medicine
710 West Napa St, Suite 1
Sonoma, CA 95476
(707) 996-9355
www.SonomaNatMed.com

Sabina Sonneman, M.D.
Redwood City, CA 94061
(415) 269-7115

Elisa Song, M.D.
Ann Wolf, M.D.
Whole Child Wellness
1601 El Camino Real, Suite 101
Belmont, CA 94002
(650) 595-KIDS (5437)

Dr. Paul M. Fleiss, MD
1824 Hillhurst Avenue
Los Angeles, CA 90027
(323) 664-1977

James Novak, MD
4440 Lamont Street
San Diego, CA 92109
(858) 272-0022

Dr Robert Sears
26933 “A” Camino De Estrella
Capistrano Beach, CA 92629
(949) 493-5437

Integrative Medical Clinic
175 Concourse Blvd,
Santa Rosa, CA 95403
707-284-9200
http://imcsr.com/ if you click on ‘Site Map’, then ‘Children’s Health’
they state their vax policy openly.

Dr Barrios
Mercy Medical
3427 Rovin Lane Cameron Park, CA 95682
(530) 676-7337

Marysville Clinic
330 H Street
Marysville, CA 95901
(530) 743-5300

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Sample Template for Medical Exemption:

…………….MD

May 00, 2016
To Whom It May Concern:

This letter is a medical exemption from vaccination. I am the pediatrician for (patient), D.O.B. _____ , 20__.

I thoroughly evaluated the past and current medical history and family history of this patient. It is my opinion that he be exempt from all vaccinations, including measles, mumps, rubella, chicken pox, polio, Hib, hepatitis B, diphtheria, tetanus, and pertussis, for the rest of childhood (through ( DATE– 2030..?) for the following reasons:

Family history of
multiple autoimmune,
neurodevelopmental
neurologic disorder
inflammatory bowel
psychiatric disorders
etc.

I agree that due to these factors, which will persist throughout childhood, there could be a severe reaction to further vaccinations.

Thank you,
_____________________MD
FAAP License:
NPI: