VaccineExemption

COVID-19 Vaccine Exemptions

Overview

Students and Staff Who are Filing for a Medical Exemption from the COVID-19 Vaccination

If you are seeking a medical accommodation or exemption, you will need to provide SCUSD with a signed, written statement from a physician (MD or DO) licensed in California which states:

  • The specific nature of the physical condition or medical circumstance for which the licensed physician does not recommend immunization.
  • Which required vaccine is being exempted (COVID-19).
  • Whether the medical exemption is permanent or temporary.
  • An expiration date no more than 12 calendar months from the date of signing, if the exemption is temporary.

Students who are seeking an exemption will be required to attach their signed, written statement from a physician to their vaccination status online form. If turning in documentation at the student’s school site, the signed, written statement will need to be provided along with the hard copy of the vaccination status form.

Volunteers who need to test routinely due to a personal need may arrange for such with their respective school site. Volunteer Groups may choose to complete a certification form to certify that their volunteers providing services at SCUSD sites are compliant with the Vaccination Requirement resolution by Tuesday, November 30, 2021. These records can be audited by Sacramento City Unified School District.

Staff Medical Exemption Filing Process

Staff members requesting an exemption to the COVID-19 vaccination can send all supporting documentation by:

  • Email to amber-pena@scusd.edu
  • Serna Center (address below) receptionist counter Attn: Amber Pena, Risk Management
  • US mail to: Sacramento City Unified School District, Attn: Risk Management Box 840, 5735 47th Ave, Sacramento, CA 95824

Download Staff Medical or Religious Belief COVID-19 Vaccine Exemption Form

SCUSD will need receipt of exemption documentation by Tuesday, November 30, 2021. Once your exemption documentation is submitted, you will be contacted by Risk Management regarding next steps. Those with an approved exemption will be required to register for regular, routine COVID-19 testing.

Students Filing for a Personal Belief Exemption from the COVID-19 Vaccination

Students who wish to file an exemption for personal beliefs (including religious) can do so by downloading the form below, scanning it and attaching it to the vaccination status online form or submitting it to their school site office. Those with an approved exemption will be required to register for regular, routine COVID-19 testing.

Download Student Personal or Religious Belief COVID-19 Vaccine Exemption Application in EnglishEspañol / SpanishHmoob / Hmong中文 / Chinese, and Tiếng Việt / Vietnamese.

Staff Filing a Request for a Religious Belief Exemption for the COVID-19 Vaccination

Staff members requesting an exemption to the COVID-19 vaccination can send all supporting documentation by:

  • Email to amber-pena@scusd.edu
  • Serna Center (address below) receptionist counter Attn: Amber Pena, Risk Management
  • US mail to: Sacramento City Unified School District, Attn: Risk Management Box 840, 5735 47th Ave, Sacramento, CA 95824

SCUSD will need receipt of exemption documentation by Tuesday, November 30, 2021. Once your exemption documentation is submitted, you will be contacted by Risk Management regarding next steps. Those with an approved exemption will be required to register for regular, routine COVID-19 testing.

Download Staff Medical or Religious Belief COVID-19 Vaccine Exemption Form