Statement of Medical Exemption
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Forms, Links, and Information
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English - 010-3041e - Statement of Medical ExemptionPDF
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French - 010-3041f - Statement of Medical ExemptionPDF
Additional Information
| Form Number | 010-3041 |
|---|---|
| Title | Statement of Medical Exemption |
| Description | To allow individuals to apply for medical exemptions for immunizations |