Utah Immunization Exemption Form - Must click all that apply. Students who attend the university of utah are required to be fully vaccinated against measles, mumps and rubella (mmr). Attach a copy of the exemption form to the back of the usir. To access the online immunization education module, click here. Fill in the exemption column with the type of exemption (religious, personal, or medical) if the student has an exemption. Click “download” to view and print the vaccination exemption form. Web to receive a utah vaccination exemption form, a legally responsible individual of a child must complete the online education module, print the utah vaccination exemption form and provide a signed copy to the school/early childhood program. Select the vaccines that apply to the exemption. For a medical exemption, a written notice signed by a licensed health care provider must also be attached to the usir. Clinical health sciences students have additional requirements (ie., students rotating in a patient care area).
To access the online immunization education module, click here. A new request must be submitted annually, unless otherwise notified. Web • the influenza exemption request is only valid for one year; Click “download” to view and print the vaccination exemption form. Give the exemption form to the school your child attends. For a medical exemption, a written notice signed by a licensed health care provider must also be attached to the usir. Clinical health sciences students have additional requirements (ie., students rotating in a patient care area). To receive a vaccination exemption form, the legally responsible individual who claims the exemption for the student must complete the online immunization education module. Must click all that apply. Students who attend the university of utah are required to be fully vaccinated against measles, mumps and rubella (mmr). Seasonal flu vaccination exemption requests must be submitted to work wellness no later than october 31 • if i am exempt from receiving an immunization, i may be required to use personal Attach a copy of the exemption form to the back of the usir. Fill in the exemption column with the type of exemption (religious, personal, or medical) if the student has an exemption. Select the vaccines that apply to the exemption. Web to receive a utah vaccination exemption form, a legally responsible individual of a child must complete the online education module, print the utah vaccination exemption form and provide a signed copy to the school/early childhood program.