Request for Religious Exemption
To apply for a religious exemption, please read the Information about Religious Exemption from Vaccine document. Once finished, fill out the Request for Religious Exemptions from Vaccine form. Return the completed document to Student Health and Counseling Services by emailing firstname.lastname@example.org.
Request for Medical Exemption
To apply for a medical exemption, please read the Information about Medical Exemption from COVID-19 Vaccine document. Once finished, fill out the Request for Medical Exemption from COVID-19 Vaccine form. Return the completed document to Student Health and Counseling Services by secure message at https://shs.upenn.edu. You may also email to email@example.com however please note that email is not secure.
What if I’m on immunization hold?
Your hold will be removed temporarily when we receive the request until a determination is reached. Once approved, the hold will not released.
If the exemption request includes the meningococcal vaccine, the Meningococcal Waiver at https://shs.wellness.upenn.edu/mening must also be submitted.
The Online Student Health History and TB Risk Screening Form must be completed regardless of exemption status.