Immunization EXEMPTION Form govst immunizations 2026

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  1. Click ‘Get Form’ to open the Immunization EXEMPTION Form in the editor.
  2. Begin by entering your name in the designated fields for last, first, and middle names.
  3. Input your date of birth in the format mm/dd/yyyy to ensure accurate processing.
  4. Provide your GSU Student ID number to link your request with your student profile.
  5. Fill in your phone number for any follow-up communications regarding your exemption request.
  6. Enter the date of your request to document when you are submitting this form.
  7. Select the reason for your exemption by checking the appropriate box based on your enrollment status.
  8. Ensure that you have your advisor sign and date the form, as this is required for submission each semester.
  9. Finally, sign and date the form yourself before submitting it either in person or via fax/mail as indicated.

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Because the COVID Vaccination Policy conflicts with my sincerely held religious beliefs and practices or membership in a church or religious body or, with my strongly held moral or ethical beliefs of what is right and wrong, I request approval to decline COVID vaccination at this time.
Texas Administrative Code (TAC) 97.62 covers the conditions under which a student can request an exemption from getting immunizations to enter their school or college. There are three conditions for exemption: If a health care provider determines that it is not safe for the student to get a certain vaccine.
There are a number of ways that someone can prove strongly held religious beliefs that getting the vaccine would contradict. Writing a formal letter requesting exemption. Getting a close friend, family member or fellow member of the clergy to write a letter. Filling out and submitting a religious exemption request form:

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All states allow exemptions from school immunization requirements for children who are unable to receive vaccines for medical reasons. State laws vary regarding non-medical exemptions, for religious or personal reasons. Personal exemptions are also referred to as philosophical exemptions by some states.
Please initial next to each of the statements below: I request a reasonable accommodation due to my sincere religious beliefs. I understand and assume the risks of non-vaccination. I accept full responsibility for my health, thus removing liability from the City to the required vaccinations.
Objection to vaccination was also related to: faith in divine protection and healing for Protestants, Catholics, Jewish and Muslims (10); the use of aborted fetal cells for vaccines production among Amish and Catholic communities (including during the COVID-19 outbreak when Senior Catholic leaders from the US and
California removed its personal and religious exemption option in 2015. Parent/guradian must complete an online educational module to receive a non-medical exemption. Connecticut removed its religious exemption option in 2021.

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