Instructions

In connection with this request, you will need to supply the following information in text format:

  1. An identification of the religion that you are relying upon in support of your exemption request.
  2. The particular religious belief that would be violated by receiving a COVID-19 vaccination, and how receiving a COVID-19 vaccination violates that belief.
  3. The connection between the above noted religious belief and your religion.
  4. Details as to how vaccination issues were addressed within your religion prior to the COVID-19 pandemic.

You will also need to upload the following document:

  1. A letter of support from your religious leader, signed and dated, certifying:
    • An identification of the religion that you are relying upon in support of your exemption request
    • The particular religious belief that would be violated by receiving a COVD-19 vaccination, and how receiving a COVID-19 vaccination violates that belief
    • The connection between the above noted religious belief and your religion
    • Details as to how vaccination issues were addressed within your religion prior to the COVID-19 pandemic.