OMB control number
Request for a Medical Exception to the COVID-19 Vaccination Requirement
OMB 3202-0005 · OSHRC.
OMB 3202-0005
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1 Request for a Medical Exception to the COVID-19 Vaccination Requirement | Form and Instruction |
| Emergency Justification Letter.pdf | Supplementary Document |
 Supporting Statement Part A 12 120 2021 FINAL.docx | Supporting Statement A |
 Request for a Medical Exception to the COVID-19 Vaccination Requirement |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202112-3202-001 | New collection (Request for a new OMB Control Number) | 2022-01-12 | Approved without change |