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CMS Vaccine Requirement Information

Additional Information

Religious Exemption Form

We have an obligation to accommodate an employee's sincerely held religious belief under Title VII of the Civil Rights Act (Title VII), unless the accommodation creates an undue hardship. A sincerely held religious belief can include an employee's religious-based objection to vaccinations. 

Download

Medical Exemption Form

There may be rare exceptions for staff who have a recognized medical contraindication and may be at risk for an adverse reaction because of an allergy to one of the vaccine components or a medical condition. 

Download

Employee Survey

Employees who are not fully vaccinated should complete the Microsoft Forms Survey and upload appropriate documents – COVID Vaccine Cards, Medical or Religious Accommodation request and appropriate provider certification forms.

 

Survey

COVID-19 Vaccine Policy

If you have any questions regarding the CMS vaccine mandate please email Covid19@CMHRegional.com.