Vaccine exemption forms now available from Florida Department of Health


The Florida Department of Health has released the forms that employees of private businesses may use to request exemptions from employer vaccine mandates.

Under legislation passed in this week’s Special Session, private employers are prohibited from mandating COVID-19 vaccines for employees without opportunity for the employees to obtain an exemption. The following forms must be accepted by employers:

The Medical Exemption form has a checkbox for the employee to indicate if the exemption is based on a pregnancy or anticipated pregnancy. The section for the doctor’s signature simply states, “It is my professional opinion as a physician or physician assistant who holds a valid, active license under chapter 458 or chapter 459, Florida Statutes, or an advanced practice registered nurse who holds a valid, active license under chapter 464, Florida Statutes, that COVID-19 vaccination is not in the best medical interest of the employee.”

The Religious Exemption form states, “I hereby declare that I decline the COVID-19 vaccination because of a sincerely held religious belief, which may include a sincerely held moral or ethical belief.” It includes this note: “An employer shall not inquire into the veracity of the employee’s religious beliefs. Pursuant to section 381.00317(2), Florida Statutes, this completed exemption statement requires the employer to allow the employee to opt-out of the employer’s COVID-19 vaccination mandate.”

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The exemption based on COVID-19 immunity states, “I hereby declare that, to the best of my knowledge, the laboratory documentation I am providing with this Exemption Statement is sufficient laboratory criteria for proof of COVID-19 immunity.” Test results from PCR, antigen, or antibody tests may be attached.

The exemption based on periodic testing states, “I agree to comply with regular periodic diagnostic testing for COVID-19, to occur not more than weekly, or upon evidence of COVID-19 symptoms, with an FDA Emergency Use Authorized or FDA Approved diagnostic COVID-19 test, at no cost to me.”

The exemption based on employer-provided personal protective equipment states, “I hereby declare that I agree to comply with my employer’s reasonable written requirement to use employer-provided personal protective equipment when in the presence of other employees or other persons.”


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