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vaccine exemption forms

Dear Members,

Please fill out any of the forms below that apply to you and submit to vaccineexemptions@cityofchicago.org.

Forms can be downloaded and filled out directly from your device. To submit, please click on the email link found on each of the forms. If you have any questions, please contact Rob Noceda or Kathy Spiewak.

Vaccine Medical Exemption Request Form

  Download

Vaccine Religious Exemption Request Form

  Download

Conscientious Objection Letter

  Download