Immunization Exemption Request

Online Student Exemption Request

Full-Time Online only students can request an exemption of the MMR and Varicella (Chicken Pox) immunization requirements. They must complete the exemption form and fax it to the Registrar's Office at 901.678.1425.

NOTE:  If you are a UofM Global student and encounter an immunization restriction, please email uofmglobal@memphis.edu.

• Online Only Immunization Exemption Request Form

Religious Exemption Request

Students may request an exemption for the immunization requirement because it conflicts with their personal religious beliefs and practices. The form must be notarized and mailed or brought in person to the Student Health Center.

• Religious Exemption Request Form

 

Medical Exemption Request

Exemptions may be requested if the student has an allergy to a vaccine component, has a valid medical condition which contraindicates receiving the vaccine, or has religious tenets prohibiting vaccinations. 

When immunizations are medically contraindicated, a physician must provide a signed written statement indicating which immunizations are contraindicated and why the immunizations are contraindicated. 

Exemption Request-Special Notes

If an exempted student contracts Measles, Mumps, Rubella, or Varicella, or if a Measles, Mumps, Rubella, or Varicella outbreak occurs, it will be the student’s responsibility to remain off campus until a physician gives written permission for the student to return to campus