Va Religious Exemption Form

Va Religious Exemption Form - Trainee, resident, intern, fee basis, or researcher) please indicate: 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. This form should be retained separately from the employee's official personnel folder. Rac will assign log number below for record keeping purposes. You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. 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 Check one statement below and complete and sign the last section of this form prior to submission to employee occupational health: Web employees should provide this form to the rac.

Please read the descriptions below to learn the criteria to request a medical or religious exception. 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. 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. 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. Received the seasonal influenza vaccine this flu season. 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:

Check one statement below and complete and sign the last section of this form prior to submission to employee occupational health: Web form prior to submission to your supervisor. Rac will assign log number below for record keeping purposes. Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval 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. Number __________________________________ the administration of immunizing agents conflicts with the above named student's/my religious tenets or. I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Please read the descriptions below to learn the criteria to request a medical or religious exception.

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Number __________________________________ The Administration Of Immunizing Agents Conflicts With The Above Named Student's/My Religious Tenets Or.

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. 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:

Please Read The Descriptions Below To Learn The Criteria To Request A Medical Or Religious Exception.

This form should be retained separately from the employee's official personnel folder. Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. 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 employees should provide this form to the rac. 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):

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.

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