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Medical Exemption / Waiver / Opt-out Request COVID-19 Vaccination 2022/2023 rev.11.10.22IMPORTANT: exemption requests are required to be submitted and approved as determined by Trinity Health. Instructions
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How to fill out medical exemption waiver opt-out

01
Obtain the medical exemption waiver opt-out form from the relevant institution or organization.
02
Fill out your personal information including name, date of birth, contact information, and medical history.
03
Provide detailed information on the reasons for requesting the medical exemption waiver opt-out.
04
Attach any supporting documentation such as doctor's notes or medical records to strengthen your case.
05
Review the completed form for accuracy and make sure all sections are filled out properly.
06
Submit the form according to the instructions provided by the institution or organization.

Who needs medical exemption waiver opt-out?

01
Individuals who have a valid medical reason that prevents them from participating in a certain activity or program may need a medical exemption waiver opt-out.
02
This could include individuals with a medical condition, allergy, or other health concern that puts them at risk if they were to participate without exemption.
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Medical exemption waiver opt-out is a process where individuals can request to be exempted from certain medical requirements or obligations.
Individuals who have a valid medical reason for not being able to comply with certain medical requirements may be required to file a medical exemption waiver opt-out.
To fill out a medical exemption waiver opt-out, individuals may need to provide documentation from a medical professional supporting their request for exemption.
The purpose of medical exemption waiver opt-out is to provide individuals with valid medical reasons the opportunity to be exempted from certain medical requirements or obligations.
The information required on a medical exemption waiver opt-out may include details of the medical condition, supporting documentation from a medical professional, and any other relevant information.
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