Gov. Tom Wolf’s administration on Friday pushed back on school districts that some accused of exploiting a loophole in its mask mandate, warning that allowing parents to file for medical exemptions without providing evidence violated the state order.

The message from the state education department didn’t threaten specific consequences, but pointed to a letter it sent this week to one district deemed noncompliant, warning that school officials could be found in violation of state laws and that the district could face a federal civil rights probe.

That letter applied to one district, but “the cautions and conditions are broadly applicable to all school entities — both public and nonpublic,” the department said Friday. It then said “any school entity simply permitting a parent’s sign-off without evidence that the student has a medical or mental health condition or disability that precludes the wearing of a face covering is not in compliance with the order.”

The warning came as reports circulated this week of school districts allowing parents to request exemptions to the school mask mandate without a doctor’s signature — and as worries grew about whether the effort would be watered down by mask opponents permitted to circumvent the rule, which Wolf’s administration imposed last week after deciding too few districts had been taking adequate measures against the coronavirus.

The order, issued by the Pennsylvania Department of Health, allows for exceptions if “wearing a face covering would either cause a medical condition, or exacerbate an existing one, including respiratory issues that impede breathing, a mental health condition, or a disability.”

Some districts are using exemption forms that don’t require a doctor to confirm a child’s medical condition, including Quakertown, where the school board voted Thursday to allow any student whose parent submits a form over the weekend to attend classes Monday without a mask.

Quakertown is modeling its exemption after the 18,000-student Central Bucks School District, where 600 to 700 people have filled out the forms, according to district solicitor Jeffrey Garton. (Angela Linch, a spokesperson for Central Bucks, said Friday that “we continue to process exemptions, and would not consider any figure to be accurate at this point.”)

Chris Spear, a Quakertown school board member, said during Thursday’s meeting that 22% of students in the nearby Pennridge School District had submitted exemption forms; officials there did not respond to requests for comment Friday.

“Most superintendents are in exemption hell,” said Jeff Sultanik, a lawyer who represents districts in the Philadelphia region and elsewhere in the state, noting varying approaches to masking exemptions. The Associated Press reported Thursday that a dozen out of 50 districts that it checked were not requiring a doctor’s signature; Pennsylvania has 500 districts.

» READ MORE: Now that Pa. has a school mask mandate, has the rancor subsided? It has not.

In some other districts with tighter requirements, requests have been sparse. In the Penn-Delco School District, where parents must submit an exemption signed by a doctor, none have yet done so, district officials said.

The Lower Merion School District — which informed parents last month that “asthma and most other medical conditions are not a contraindication to the use of a face mask” — has received fewer than a dozen exemption requests, primarily for students with significant disabilities, according to Terry Quinlan, the district’s lead supervisor of school health and student safety.

“Our experience has been that even our students with significant disabilities have been able to wear masks at least for part of the day,” Quinlan said. She said exemption decisions are made in conjunction with the student’s health-care provider and IEP or 504 team — referring to school staff assigned to students with disabilities, in line with federal law.

The Pennsylvania Department of Education recommended last week that schools grant mask exemptions “in accordance with eligibility” under federal laws protecting students with disabilities. School districts, it said, “should follow their established processes for determining student eligibility under those laws, including any medical documentation that they would normally require.”

But lawyers told the Quakertown school board Thursday that doctors didn’t need to sign off on mask exemption requests, and said the district wouldn’t have to evaluate a child for a disability just because a parent claims a medical or mental health condition preventing mask-wearing.

Instead, they advised that a parent could waive the evaluation — and also sign a form agreeing not to sue the district for failing to provide other accommodations to their child.

» READ MORE: Gov. Tom Wolf and teachers say kids are cool with masks: ‘It feels like an adult problem’

Some parents told the Quakertown board their children had suffered migraines, experienced trouble breathing, and developed anxiety from masking. “You are scarring and scaring our children, all because they want to breathe fresh air,” one woman said.

“There’s a lot of health causes that this creates and it’s simply because of the mask-wearing,” said board member Ronald Jackson. “That’s the only reason this exists. And the problem is that, we can’t say that. We can’t say we don’t want them to wear the mask because it causes injury or whatever to them. We can say that, but then they’ve got to go through these hurdles, unfortunately.”

The CDC and American Academy of Pediatrics say children should wear masks in school. “It’s hard for me to believe that you would see significant ill health effects from the type of facial coverings that we recommend the public wear,” said MeiLan Han, a doctor and professor of medicine at the University of Michigan who focuses on respiratory diseases.

She noted that last year, the American Thoracic Society, an organization “dedicated to accelerating the advancement of global respiratory health,” said that even individuals with chronic lung disease should be able to wear cloth masks.

Parents worried about allowing more students into schools without masks have been pleading with boards to keep exemption rules tight. “Please don’t try to find loopholes to allow unqualified students to go to school maskless,” one woman told the Quakertown board. “Please don’t defy the state health department’s masking mandate.”

Inquirer staff writer Juliana Reyes contributed to this article.