Vaccine Exemption Request

Vaccine Exemption Request

Complete the form below if you require a vaccine exemption for medical, religious, or other reasons. Records will be kept on file with the Health and Wellness Coordinator.
Name*

First NameLast Name
Email*
example@example.com
Your Relationship to the AAC*
Reason for Vaccine Exemption*
All information entered is confidential.

All Students, Faculty, and Staff are required to consent to and cooperate with the AAC Success and Wellness Plan and agree to protocols communicated. To find a copy of our COVID-19 Success and Wellness Plan, visit www.artacademy.edu/covid19
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