OMB control number
Request for a Medical Exception to the COVID-19 Vaccination Requirement
OMB 3240-0040 · SSS.
Consistent with Executive Order 14043, of September 9, 2021, “Requiring Coronavirus Disease 2019 Vaccination for Federal Employees, and included within the Safer Federal Workforce Task Force Guidance mandating all Federal employees be vaccinated by November 22, 2021, the Selective Service System (SSS) has established specific safety protocols for individuals fully vaccinated and not fully vaccinated against coronavirus disease 2019 (COVID-19). Individuals who are not fully vaccinated against COVID-19 by November 22, 2021, or who choose not to provide this information will be required to comply with applicable OMB, OPM and SSS guidance for individuals not fully vaccinated against COVID-19, including wearing masks regardless of the transmission rate in a given area, physical distancing, regular screening testing, and adhering to applicable travel requirements. SSS employees may request an exemption on the basis of a medical condition or circumstance. Exemptions will be granted in limited circumstances and only where legally required. The Medical Exception Form will be provided directly to the individuals who are requesting a medical exemption.
The latest form for Request for a Medical Exception to the COVID-19 Vaccination Requirement expires 2026-06-30 and can be found here.
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Supplementary Document |
Supplementary Document |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
| Revision of a currently approved collection | 2022-05-16 | ||
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Approved with change |
New collection (Request for a new OMB Control Number) | 2022-01-13 |