1412 West Washington Boulevard Chicago, Illinois 60607-1821 (312) 733-7776

Vaccine Exemption Forms


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
Vaccine Religious Exemption Request Form
Conscientious Objection Letter

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We pledge ourselves to promote the health and welfare of all Chicago Law Enforcement Officers and their immediate families; to raise and maintain the professional standards of the Chicago Law Enforcement Officer; and to represent Chicago Police Officers in affairs relative to the administration of the department.

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