State medical regulators on Friday suspended the license of a Durham physician accused of providing bogus exemption forms for the COVID-19 vaccine.

Health authorities received an anonymous complaint in July that Dr. Sue McIntosh was mailing signed exemption forms to anyone who asked, with no examinations, authorities said. At an emergency meeting, the Connecticut Medical Examining Board suspended the retired doctor’s state license to practice medicine.

Forms McIntosh provided related to COVID-19 vaccines, general vaccines, COVID testing and medical opposition to wearing facial masks, state health officials said.

An exemption calls for a clinical assessment of a patient’s condition to determine if a vaccination poses a health risk. An investigator with the state health department sent a self-addressed envelope to McIntosh to test whether she would send back signed documents certifying an allergy, according to an affidavit included with state documents.

On Sept. 16, the investigator received a return envelope from McIntosh that included forms signed by her titled, “Medical Vaccine Exemption-covid,”“Exemption for Routine Invasive COVID Testing” and “Medical Vaccine Exemption-General,” according to the affidavit.

Under “Instructions for Medical Exemptions,” McIntosh wrote that she did not provide personalized exemptions, but an enclosed exemption for aluminum toxicity could be used for any vaccine.

“You may copy and distribute as many forms as you wish to anyone,” she wrote, according to state officials, ending her response letter with, “Let freedom ring!”

“These actions by Dr. McIntosh are irresponsible and unacceptable,” state Health Commissioner Manisha Juthani said. “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.”

Any signed, blank exemption forms from Dr. McIntosh are invalid, Juthani said. These include forms she provided to people seeking medical exemptions under the governor’s executive orders regarding long-term care and state workers and contractors.

McIntosh could not be reached Friday. Her license will be suspended pending a final decision by the board.

She graduated from the University of Tennessee College of Medicine in 1969 and was issued Connecticut licenses in 1971, background documents show. McIntosh is certified by the American Board of Pediatrics with a subspecialty in hematology-oncology.

Jesse Leavenworth can be reached at jleavenworth@courant.com