Please provide a written statement addressing all of the following elements:.You will be notified of the outcome of this request. When a religious exemption is requested, Adelphi University may require supporting documentation.

Please provide a written statement addressing all of the following elements: When a religious exemption is requested, Adelphi University may require supporting documentation. Public Health Law Section 2165 does not allow for philosophical, political, scientific or sociological exemptions. Prior religious exemption statements addressed to other institutions are not considered valid. Each statement requesting a religious exemption must be specific to Adelphi University. This statement must demonstrate that the student, or his/her parent(s) or guardian(s) holds sincere and genuine religious beliefs which are contrary to the practice of immunization. Students under 18 years old must submit such a statement signed by his/her parent(s) or guardian(s) to qualify for religious exemption. If you are assigned to a site not permitting a religious exemption to a COVID-19 vaccine requirement, you may request another accommodation from KU Medical Center (i.e., leave of absence or alternative site location) by completing and submitting a request for another religious accommodation.A student must submit a written statement stating that they hold religious beliefs contrary to the practice of immunization in order to qualify for a religious exemption. Other sites are not permitting a religious exemption for students. If your clinical site directs that KU Medical Center review and decide religious exemption requests, please complete and submit the form. Please know that some clinical sites are still deciding how they will administer student requests for a religious exemption, and have not yet communicated their processes to KU Medical Center. Please communicate with your school/program to better understand the clinical site's process, and which form to complete. Some sites reviewing and deciding exemptions have developed their own forms for students to submit directly to them. Some KU Medical Center partners are administering their own religious exemption request processes while other sites are directing KU Medical Center to perform that review. If the clinical site you are assigned to is administering the exemption review process, you may not need to complete or submit any forms to KU Medical Center, unless otherwise directed by the site. KU Medical Center clinical partners are now requiring all students to have received the COVID vaccine before being allowed to begin or continue their clinical or programmatic experiences. Student Vaccination Religious Exemption Request Form COVID Vaccine Exemption Request Student Vaccination Medical Exemption Request Form Please complete the form below to request a medical or religious exemption for a required vaccination (Measles, Mumps, Rubella, Hepatitis B, Influenza, varicella, Tdap Tetanus, Diphtheria, Pertussis). You will need to upload the completed form in order to submit your request. If you are completing a medical exemption form for a required vaccination or a Covid-19 vaccine, please make sure to take the medical attestation form to a licensed independent provider (MD, DO, APRN) to complete the attestation.

Religious exemption vaccination letter