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STATEMENT OF MEDICAL EXEMPTION (Employees, Volunteers or Contractors) MANDATORY VACCINATION FOR CAMPUS Please email completed form to hrvaccine@uwindsor.ca SECTION 1 REQUESTER INFORMATION Last NameFirst
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How to fill out statement of medical exemption
01
Obtain a medical exemption form from a healthcare provider.
02
Fill out your personal information such as name, date of birth, and contact information.
03
Provide details about your medical condition that warrants the exemption.
04
Have your healthcare provider sign and date the form.
05
Submit the completed form to the appropriate organization or institution requiring the exemption.
Who needs statement of medical exemption?
01
Individuals who have a medical condition that prevents them from receiving certain vaccinations or medical treatments.
02
Students who need to be excused from school vaccination requirements.
03
Employees who require accommodations in the workplace due to medical reasons.
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What is statement of medical exemption?
Statement of medical exemption is a document filled out by a healthcare provider stating that an individual is exempt from certain medical requirements.
Who is required to file statement of medical exemption?
Individuals who have a medical condition or other valid reason for not meeting certain medical requirements are required to file a statement of medical exemption.
How to fill out statement of medical exemption?
To fill out a statement of medical exemption, individuals must have their healthcare provider complete the form, providing details about the medical condition or reason for exemption.
What is the purpose of statement of medical exemption?
The purpose of statement of medical exemption is to provide documentation to support an individual's exemption from certain medical requirements.
What information must be reported on statement of medical exemption?
Information such as the individual's name, medical condition or reason for exemption, healthcare provider's information, and signature must be reported on the statement of medical exemption.
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