Va Religious Exemption Form

Religious exemption for vaccinations.pdf Google Drive

Va Religious Exemption Form. Form cre 1 is an affidavit stating that the administration of immunizing agents conflicts with the student's religious tenets or practices. Received the seasonal influenza vaccine this flu season.

I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Web employees should provide this form to the rac. The student or his parent or guardian submits a notarized certificate of religious exemption (form cre 1), to the admitting official of the school to which the student is seeking admission. Web regarding disability requests, approvals will be annotated on both the va form 10230a and va form 0857f, accommodation request determination, in accordance with va handbook 5975.1. Web form prior to submission to your supervisor. Trainee, resident, intern, fee basis, or researcher) please indicate: Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Fully vaccinated (required documentation attached): Form cre 1 is an affidavit stating that the administration of immunizing agents conflicts with the student's religious tenets or practices. Rac will assign log number below for record keeping purposes.

Rac will assign log number below for record keeping purposes. Rac will assign log number below for record keeping purposes. I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Web form prior to submission to your supervisor. Web regarding disability requests, approvals will be annotated on both the va form 10230a and va form 0857f, accommodation request determination, in accordance with va handbook 5975.1. The student or his parent or guardian submits a notarized certificate of religious exemption (form cre 1), to the admitting official of the school to which the student is seeking admission. You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. This form should be retained separately from the employee's official personnel folder. Please read the descriptions below to learn the criteria to request a medical or religious exception. Received the seasonal influenza vaccine this flu season.