CON Request for Waiver of Faculty Immunizations or CPR Requirements

From University of Nebraska Medical Center
Revision as of 13:42, October 7, 2019 by Jbarrier (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
Home   Appendices                    


UNIVERSITY OF NEBRASKA MEDICAL CENTER
COLLEGE OF NURSING
Request for Waiver of Faculty Immunizations or CPR Requirements Subsection: Appendix M
Section - Appendices Originating Date: October 2003
Responsible Reviewing Agency:
Executive Council
Faculty Coordinating Council
Revised: February 2008
Reviewed: May 2016
Revised: March 2018
Related documents:
4.2.12


I, ________________________________________________, request a waiver of requirements for the following immunization(s) and/or CPR (please list):

for the following reason(s) (ex. allergy):

_______________________________________________   _______________________________
Faculty Signature   Date
 
Submit completed/signed form to conrecords@unmc.edu
 
Note: For recurring requirements, form should be submitted each time requirements comes due.