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COVID-19 VACCINATION EXEMPTION REQUEST FORM Last nameFirst name DOB (month day year)AddressStudent ID Numbered Phone Number Select/Highlight your campus location(s):Philadelphia Main CampusSelect/Highlight

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How to fill out covid-19 vaccination exemption request

01

To fill out a COVID-19 vaccination exemption request, follow these steps:

02

Start by downloading the official exemption request form from your local health department website or the website provided by relevant authorities.

03

Read the instructions on the form carefully and gather any supporting documents that may be required, such as medical records or a doctor's note explaining the reason for exemption.

04

Complete the personal information section of the form, including your full name, date of birth, address, contact details, and any other requested information.

05

Provide details about your vaccination history, including the vaccines you have already received, dates of administration, and any adverse reactions or medical concerns you may have experienced.

06

Clearly state the reason for requesting an exemption from COVID-19 vaccination. This could be due to medical conditions, religious beliefs, or any other authorized exemptions as defined by local authorities.

07

Attach any supporting documents that strengthen your case for an exemption. These could include medical records, doctor's notes, or religious affiliation certificates.

08

Review the completed form and make sure all information is accurate and properly filled out.

09

Submit the exemption request form to the designated authority or the specified address mentioned on the form. Follow any additional instructions provided for submission.

10

Keep a copy of the completed form and supporting documents for your records.

11

Wait for a response from the relevant authorities regarding the approval or denial of your exemption request. Make sure to follow up if required.

Who needs covid-19 vaccination exemption request?

01

Individuals who have valid reasons for not receiving the COVID-19 vaccine may need to submit a COVID-19 vaccination exemption request. This may include individuals with medical conditions or allergies that prevent them from being vaccinated, individuals who hold strong religious beliefs that prohibit vaccination, or individuals who are exempted by local authorities due to specific requirements or circumstances.

02

It is important to note that the criteria for needing a COVID-19 vaccination exemption request may vary depending on local health regulations and guidelines. Therefore, individuals should consult the specific guidelines provided by their local health department or relevant authorities to determine if they fall into the category of those who need to submit a vaccination exemption request.

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What is covid-19 vaccination exemption request?

It is a formal request made by an individual to be exempted from receiving the covid-19 vaccination.

Who is required to file covid-19 vaccination exemption request?

Individuals who have valid reasons for not being able to receive the covid-19 vaccination are required to file the exemption request.

How to fill out covid-19 vaccination exemption request?

The exemption request can typically be filled out online or on a physical form provided by the relevant authorities.

What is the purpose of covid-19 vaccination exemption request?

The purpose is to provide individuals with a valid reason for not being able to receive the vaccination, an opportunity to be exempted.

What information must be reported on covid-19 vaccination exemption request?

The request usually requires the individual's personal information, reason for exemption, and any supporting documentation.

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