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Medical Exemption Request – COVID-19 Vaccine

2021

This sample form was developed in connection with CAPLAW’s Vaccines and the COVID-19 Pandemic series of conversations. The template allows employees to request an exemption from an employee vaccination mandate and provide corroborating information and documentation. It also contains some recordkeeping questions that a CAA might use to standardize and document its process of providing reasonable accommodations. CAPLAW recommends adapting this form to meet the needs of your agency in consultation with local counsel in your state.

Related Resources:

Religious Exemption Request – COVID-19 Vaccine

Religious Exemption Request – COVID-19 Vaccine

This sample form was developed in connection with CAPLAW’s Vaccines and the COVID-19 Pandemic series of conversations. The template allows employees to request an exemption from an employee vaccination mandate and provide corroborating information and documentation. It...

CAPLAW Legal Updates

CAPLAW Legal Updates

This archive of CAPLAW legal updates and e-News bulletins contains timely information on the legal and financial topics important to the Community Action network.

CAPLAW Legal Updates

CAPLAW News Alerts

This archive of CAPLAW news alerts contains breaking news on the legal and financial topics important to the Community Action network.