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Va Religious Exemption Form

Va Religious Exemption Form - This form should be retained separately from the employee's official personnel folder. Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Please read the descriptions below to learn the criteria to request a medical or religious exception. Fully vaccinated (required documentation attached): Web employees should provide this form to the rac. I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. Form cre 1 is an affidavit stating that the administration of immunizing agents conflicts with the student's religious tenets or practices. 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.

Fully vaccinated (required documentation attached): 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. This form should be retained separately from the employee's official personnel folder. You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. Number __________________________________ the administration of immunizing agents conflicts with the above named student's/my religious tenets or. Rac will assign log number below for record keeping purposes. Received the seasonal influenza vaccine this flu season. 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 commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Web employees should provide this form to the rac.

Trainee, resident, intern, fee basis, or researcher) please indicate: Number __________________________________ the administration of immunizing agents conflicts with the above named student's/my religious tenets or. Received the seasonal influenza vaccine this flu season. Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval Fully vaccinated (required documentation attached): You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. Rac will assign log number below for record keeping purposes. Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Web form prior to submission to your supervisor. Web employees should provide this form to the rac.

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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. Received the seasonal influenza vaccine this flu season. Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval I have read and fully understand the information on this form and have been given the opportunity to have my questions answered.

Fully Vaccinated (Required Documentation Attached):

Web employees should provide this form to the rac. 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. Web form prior to submission to your supervisor.

Check One Statement Below And Complete And Sign The Last Section Of This Form Prior To Submission To Employee Occupational Health:

Trainee, resident, intern, fee basis, or researcher) please indicate: You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. Number __________________________________ the administration of immunizing agents conflicts with the above named student's/my religious tenets or. 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.

Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d.

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