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State University of New York at Fulton Montgomery Community College (FCC) COVID-19 Vaccination Requirement Temporary Exemption Request Form Students who have received one shot of a 2shot COVID-19
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Download the fmcovid-19-medical-exemption-form-102721pdf from the official website.
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Fill out your personal information accurately, including name, address, contact information, and date of birth.
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Provide detailed information about your medical condition that qualifies you for a Covid-19 exemption.
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Who needs fmcovid-19-medical-exemption-form-102721pdf?

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Individuals who have a medical condition that makes them ineligible or unsafe to receive the Covid-19 vaccine.
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The fmCOVID-19 Medical Exemption Form 102721 is a document designed for individuals seeking an exemption from COVID-19 vaccination mandates for medical reasons.
Individuals who have a medical condition that contraindicates them from receiving the COVID-19 vaccine are required to file this form to request an exemption.
To fill out the form, individuals must provide personal details, a description of the medical condition, any supporting documentation from a healthcare provider, and their signature.
The purpose of the form is to formally request a medical exemption to vaccination due to health issues, thereby allowing individuals to comply with vaccination policies without receiving the vaccine.
The form requires reporting personal identification information, details of the medical condition, documentation from healthcare providers, and any relevant medical history.
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