Employee Covid-19 Vaccination Exemption Submission

If you are requesting a qualified exemption based on medical or religious grounds:

• Please complete the appropriate form and submit using the instructions below. 
  • Medical exemption
    • Please note: Medical Licenses that we accept include MD, DO, NP, PA
  • Religious exemption

AND 

• A photo of your photo ID (Lancer ID, driver's license or valid identification card)

Your submission will be reviewed and your employee record will be updated accordingly.

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Two Ways to Submit