A retired Connecticut physician and surgeon had her license suspended Friday by a state medical board for allegedly providing people she had not treated with blank vaccine, mask-wearing and other exemption forms, so long as they sent her a self-addressed stamped envelope in the mail requesting the paperwork.

The state Department of Public Health said it received an anonymous tip in July about Dr. Sue Mcintosh of Durham sending people fraudulent exemption forms. After an investigation, DPH called on the Connecticut Medical Examining Board to hold Friday’s emergency hearing and summarily suspend the doctor, saying she poses a “clear and immediate danger to public health and safety.”

The panel voted unanimously in favor of the suspension. A full hearing on the merits of the case is scheduled for Oct. 5.

A message was left seeking comment with Mcintosh.

State officials allege Mcintosh provided an unknown number of blank, signed forms exempting people from the COVID-19 and other vaccines, as well as mandatory mask-wearing and “routine invasive COVID testing.” The Department of Public Health obtained a packet of the bogus forms after a state investigator sent a request to Mcintosh.

In a letter titled “Instructions for Medical Exemptions,” Mcintosh said the recipients “may copy and distribute as many forms as you wish to anyone.” She advised them to “keep blank copies for yourself for future use” and to fill in the name and date in black ink. She also provided blank forms that stated whoever filled them out had a “history of anaphylaxis to polyethylene glycol” and cannot be vaccinated for COVID-19 or was “highly allergic” to aluminum and mercury and cannot be vaccinated for any vaccine in general.

Mcintosh, who wrote that she does not provide “personalized exemptions,” signed the instruction letter with, “Let freedom ring!”

Other blank forms that DPH obtained exempted people from COVID testing and the wearing of face masks.

“These actions by Dr. Mcintosh are irresponsible and unacceptable,” Dr. Manisha Juthani, the state’s public health commissioner, said in a written statement. “Her practice of medicine represents a clear and immediate danger to the public health and safety of our communities. The suspension of her license should serve as a warning to other practitioners that this conduct deviates from the standard of care and is subject to serious discipline.”

The commissioner said any signed, blank exemption forms from Mcintosh are invalid.

According to the state’s public health department, Mcintosh is a 1969 graduate of the University of Tennessee College of Medicine and was issued a Connecticut surgeon and physician license in 1971. She is certified by the American Board of Pediatrics with subspecialty in Hematology-Oncology.

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