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COVID-19 Vaccination and Testing: Religious Exemption/Accommodation Request Form

Author: Kim Freeman, Freeman Legal Consulting, LLC

When to Use

An employee may request an exemption and/or a reasonable accommodation from an organization's COVID-19 vaccination, testing and face covering requirements if vaccination, testing for COVID-19 and/or wearing a face covering conflicts with the employee's sincerely held religious belief, practice or observance as defined by Title VII of the Civil Rights Act of 1964. An employee may be entitled to an accommodation if the accommodation does not impose an undue hardship on the employer.

This form is for use by employees who seek an exemption from COVID-19 vaccination, testing or face covering requirements due to their sincerely held religious belief, practice or observance.

Customizable Form