Student Vaccination Exception Request

Student Affairs
200 University Parkway, Suite 317
Yakima WA 98901
Phone: 509-249-7724
Fax: 509-249-7909
Student Vaccination Exception Request
Applicants and students may be entitled to a vaccination exception. The exception request needs to include information as to why the exception is needed along with any supporting documentation.
Full Name*

First NameLast Name
PNWU ID (no dashes)*
Program/Class*
Email*
Phone Number*

Area CodePhone Number
Reason for requesting exception:*

MedicalReligious
List vaccinations for which you are requesting exceptions.*
(e.g., COVID, MMR, Influenza)
4. Please provide a reason/explanation for your request.*
Medical Documentation*

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