Yellow fever exemption letter template 2026

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  1. Click ‘Get Form’ to open the yellow fever exemption letter template in the editor.
  2. Begin by entering your personal information at the top of the form, including your full name, address, and contact details. This ensures that the letter is personalized and can be easily identified.
  3. In the section regarding medical grounds for exemption, clearly state the reason for your exemption. Choose from contraindications, precautions, or situations with no risk of disease transmission as applicable.
  4. Include any relevant medical history or documentation that supports your request for an exemption. This may include allergies or other health conditions that prevent vaccination.
  5. Finally, ensure that a supervising clinician reviews and signs the letter. Their signature adds credibility and authority to your exemption request.

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California removed its personal and religious exemption option in 2015.
my health and the health of everyone with whom I have contact, including my coworkers and all patients in this healthcare facility. Despite these facts, I am choosing to decline influenza vaccination for the following reasons: I understand that I can change my mind at any time and accept influenza vaccination.
Those found not in possession of such Valid certificate or defective certificate as enumerated by the WHO, are upon reporting by the Immigration Officers are quarantined for a period till the YF certificate becomes valid or until a period of six days, reckoned from the date of last possible exposure to infection, has
Countries Where Yellow Fever Risk Exists RegionDetails French Guiana Vaccination is required for all travelers to French Guiana. Gabon Vaccination is required for all travelers to Gabon. Gambia Required if arriving from a region with yellow fever. Ghana Vaccination is required for all travelers to Ghana.45 more rows
If you need a vaccination certificate for the country youre visiting but youre not able to have the vaccine, contact a yellow fever vaccination centre. They may provide you with an exemption letter, which may be accepted by officials in countries that usually require a vaccination certificate.

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Moreover, some countries require proof of certain vaccinations, such as the yellow fever vaccine, for entry. Failure to provide a valid vaccination certificate can result in denied entry or mandatory quarantine.
Medical waivers (exemptions) Reasons other than medical contraindications or precautions are not acceptable for exemption from vaccination. A YF vaccine provider issuing a medical waiver for YF vaccine should complete and sign the Medical Contraindications to Vaccination section of the ICVP (Figure 4.21.2).

yellow fever waiver form