Student Vaccination Exemption Request

If you are completing a medical exemption form for a required vaccination or a Covid-19 vaccine, please make sure to take the medical attestation form to a licensed independent provider (MD, DO, APRN) to complete the attestation.  You will need to upload the completed form in order to submit your request.

MEDICAL ATTESTATION PDF FORM 

Please complete the form below to request a medical or religious exemption for a required vaccination (Measles, Mumps, Rubella, Hepatitis B, Influenza, varicella, Tdap Tetanus, Diphtheria, Pertussis).

Student Vaccination Medical Exemption Request Form

Student Vaccination Religious Exemption Request Form

COVID Vaccine Exemption Request

KU Medical Center clinical partners are now requiring all students to have received the COVID vaccine before being allowed to begin or continue their clinical or programmatic experiences.  Some KU Medical Center partners are administering their own religious exemption request processes while other sites are directing KU Medical Center to perform that review. If the clinical site you are assigned to is administering the exemption review process, you may not need to complete or submit any forms to KU Medical Center, unless otherwise directed by the site.  Some sites reviewing and deciding exemptions have developed their own forms for students to submit directly to them.  Please communicate with your school/program to better understand the clinical site's process, and which form to complete.  Please know that some clinical sites are still deciding how they will administer student requests for a religious exemption, and have not yet communicated their processes to KU Medical Center.

If your clinical site directs that KU Medical Center review and decide religious exemption requests, please complete and submit the form.

Covid-19 Religious Exemption Form

Covid-19 Medical Exemption Form

Other sites are not permitting a religious exemption for students. If you are assigned to a site not permitting a religious exemption to a COVID-19 vaccine requirement, you may request another accommodation from KU Medical Center (i.e., leave of absence or alternative site location) by completing and submitting a request for another religious accommodation.