Sign in to your account, upload the Vaccination Exemption Forms Printable, and open in the editor. 3. hmO0}MyPRlC^&U6sD@R'gs- p( / I?2rPJu.)Q0l |UhP!H=P 5pzM^ AbV%Zm! All 50 states and the District of Columbia allow medical exemptions. To request a medical exception or delay from the COVID-19 vaccination requirement using this form: You must complete Part 1 of this form. Saving Lives, Protecting People, School Vaccination Requirements and Exemptions, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. oF=l#MsX!/M{au!P?kI>'1mn' w0 . You may be trying to access this site from a secured browser on the server. MEN"l=Xv|W'?=m9i8R\Dhkk[`rmg3PoP#||W&nV@lU)9nQa[b;)BU7[_fZ k'PtqP5TQySm|Xl hbbd``b`^$WUH0!`b7.HpLA`@u "%l@D ~L CBg ` r PDF Request for Religious Exemption to The Covid-19 Vaccine Form PDF Covid-19 Vaccine Exemption Request Form 2021-22 1102 0 obj <>/Filter/FlateDecode/ID[<7C7BAB49AA65F547B4563FA3CC3F0FA7>]/Index[1072 60]/Info 1071 0 R/Length 124/Prev 101540/Root 1073 0 R/Size 1132/Type/XRef/W[1 2 1]>>stream 0 Begin putting your signature on declaration of vaccination exemption welcome with our solution and join the numerous happy clients whove already experienced the benefits of in-mail signing. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. You can download the signed [Form] to your device or share it with other parties involved with a link or by email, as a result. Exemptions from state or local requirements may apply to some children. PHILOSOPHICAL/STRONG MORAL OR ETHICAL CONVICTION EXEMPTION State your reason for requesting this exemption. The request must also be signed by the employee. endstream endobj 10 0 obj <> endobj 11 0 obj <>/MediaBox[0 0 792.96 612.96]/Parent 7 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/Tabs/S/Type/Page>> endobj 12 0 obj <>stream
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