Nebraska Department of Health and Human Services: Immunization Religious Affidavit
Nebraska Revised Statute 79-221 Immunization; when not required.
Immunization shall not be required for a student's enrollment in any school in this state if he or she submits to the admitting official either of the following:
(1) A statement signed by a physician, a physician assistant, or an advanced practice registered nurse practicing under and in accordance with his or her respective certification act, stating that, in the health care provider's opinion, the immunizations required would be injurious to the health and well-being of the student or any member of the student's family or household; or
(2) An affidavit signed by the student or, if he or she is a minor, by a legally authorized representative of the student, stating that the immunization conflicts with the tenets and practice of a recognized religious denomination of which the student is an adherent or member or that immunization conflicts with the personal and sincerely followed religious beliefs of the student.
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