Incomplete/Blank Exemption Form

The exemption form you submitted is missing some required information. Please make sure your form includes:

• Your full name and date of birth

• The type of exemption you’re requesting (medical, religious, etc.)

• The reason for your exemption request

• The specific vaccine(s) you are requesting an exemption for

Once all of this information is included, please resubmit your form.

If you have any questions please contact our support team via live chat directly from your account or email us at help@medproctor.com 

Thanks!