Va Religious Exemption Form

Va Form Exemption Fill Out and Sign Printable PDF Template signNow

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. Trainee, resident, intern, fee basis, or researcher) please indicate:

Received the seasonal influenza vaccine this flu season. This form should be retained separately from the employee's official personnel folder. 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. 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. 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. Check one statement below and complete and sign the last section of this form prior to submission to employee occupational health: 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.

Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval 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. 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. I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Rac will assign log number below for record keeping purposes. Web form prior to submission to your supervisor. 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. 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.