Request for a Medical Exception to the COVID-19 Vaccination Requirement

OMB 3440-0002

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 Request for a Medical Exception to the COVID-19 Vaccination Requirement Form
11-08-21_LTR_Medical Exceptions_21-01789_U_Initial.pdf Supporting Statement B
ATTACH 2 (Support Statement A)_U.pdf Supporting Statement A
Request for a Medical Exception to the COVID-19 Vaccination Requirement Form