№ lp_2_1_23493
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Institutional medical exemption form outlining vaccination requirements, contraindication certification by a licensed health care provider, student or guardian declaration, and administrative review procedures for enrollment at California Institute of the Arts.
Institution:
California Institute of the Arts
Department:
CalArts Student Health
Program:
CalArts Residence Life Program
Country:
United States
Subject:
Vaccination requirements and medical exemption
Document Type:
Medical exemption form
Vaccines Referenced:
Measles/Mumps/Rubella (MMR); Meningococcal conjugate (ACYW); Meningitis (MCV4 or MPV4); Varicella; Meningococcal Meningitis
Issuing Authority:
California Institute of the Arts
Applicable To:
Students; Parents/Guardians of students under 18 years old
Related Authority:
Centers for Disease Control and Prevention (CDC)
Fields Included:
Health Care Provider certification; Student declaration; Institutional approval section
Purpose:
Request and certification of exemption from required vaccinations
Geographical Scope:
California
Administrative Section:
For use by CalArts Student Health staff only
Price: 8 / 10 USD
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The file will be delivered to the email address provided at checkout within 12 hours.
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2021
Region / City:
Elgin, Texas
Theme:
COVID-19 vaccinations and testing
Document Type:
Press release
Author:
Amy Miller
Organization:
City of Elgin Main Street program, COVAC Ops, Bastrop County Office of Emergency Management, St Davids Foundation, Bastrop County Cares, Community Wellness America
Target Audience:
General public, festival attendees
Event Date:
October 23, 2021
Date of Approval:
October 21, 2021
Date of Changes:
None
Note:
Year
Topic:
Rabies Vaccination, Rabies Titre Test
Document Type:
Official Veterinary Declaration
Institution:
Ministry for Primary Industries (MPI)
Author:
Official Veterinarian
Target Audience:
Veterinarians, Government Authorities
Context:
Official form used for certifying rabies vaccination and titre test results in accordance with New Zealand’s import requirements.
Year:
2026
Region / City:
United Kingdom
Subject:
Health, Vaccinations
Document Type:
Health Information Leaflet
Organization / Institution:
NHS
Author:
Unknown
Target Audience:
Patients with long-term heart conditions
Period of Validity:
Annual (flu season)
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Topic:
Chronic Liver Disease, Flu Vaccination
Document Type:
Informational Leaflet
Organization:
NHS
Author:
British Liver Trust
Target Audience:
Patients with chronic liver disease
Period of Validity:
Annual (Flu Season)
Year:
2023
Region / City:
Perth
Topic:
COVID-19 Vaccination Promotion
Document Type:
Entry Form
Organization / Institution:
NACCHO
Author:
NACCHO
Target Audience:
Aboriginal Community Controlled Health Organisations and their representatives
Period of Action:
2023
Date of Approval:
Not specified
Date of Changes:
Not specified
Year:
2021–2023
Institution:
Oglala Lakota College
Document Type:
Policy and Procedure
Topic:
COVID-19, Student Vaccinations, Health and Safety
Audience:
Students, Faculty, Staff
Approval Dates:
12-08-2021, 08-31-2022, 01-25-2023, 08-30-2023
Requirements:
Full COVID-19 vaccination or approved exemption
Exemption Types:
Medical, Disability, Spiritual/Religious/Personal
Process:
Submission of vaccination documentation or exemption request forms, review by College Center Director
Confidentiality:
Vaccination and health records are kept confidential
Instruction Modes:
Face-to-face, RBVAC, Hybrid, Alternate site delivery
Restrictions:
Non-vaccinated students without approved exemptions cannot attend in-person courses or activities
Appeal Process:
Enrollment Management Director reviews exemption appeals
Guidelines Source:
Oglala Sioux Tribal Ordinance and OLC Health Administration
Year:
2021
Region / City:
Washington State
Topic:
COVID-19 Vaccinations in Long-Term Care Facilities
Document Type:
Guideline
Organization / Institution:
Department of Health
Author:
Centers for Disease Control and Prevention (CDC)
Target Audience:
Long-term care facility staff, pharmacists, healthcare providers
Effective Period:
Ongoing
Approval Date:
Not specified
Revision Date:
Not specified
Vaccine:
COVID-19
Vaccine Type:
Pfizer-BioNTech, Moderna, Janssen/Johnson & Johnson
Storage Requirements:
Cold-chain storage
Monitoring:
Temperature monitoring
Collaboration Required:
Yes, between pharmacies, long-term care facilities, and healthcare providers
Procedure:
Onsite vaccination
Vaccine Administration:
By authorized providers
Transportation:
Guidelines for vaccine transport and safety
Year:
[Year]
Region / city:
Maryland, USA
Type of document:
Official school correspondence
Institution:
[Name of School]
Author:
School representative
Target audience:
Parents or guardians of students
Purpose:
Notification of missing vaccinations and temporary school exclusion
Applicable period:
Until proof of vaccination is provided
Date of issue:
[Month, Date, Year]
Year:
2024
Region / City:
South Australia
Subject:
Health Care Worker Vaccination and Screening Refusal
Document Type:
Policy and Procedure
Organization / Institution:
SA Health
Author:
SA Health
Target Audience:
Health Care Workers, SA Health Managers
Effective Period:
Ongoing
Approval Date:
2024-07-27
Date of Changes:
2024-07-27
Year:
2026
Region / City:
Not specified
Topic:
Maternal immunisation
Document Type:
Quality Improvement Plan
Organization:
add practice name
Author:
Practice Team
Target Audience:
Healthcare providers in antenatal care
Implementation Period:
From initial baseline report to final review meeting
Key Dates:
Baseline data report generated, implementation dates, review meetings
QI Methods:
Ask-Do-Describe framework, monitoring, and performance review
Vaccines Covered:
Influenza, Pertussis
Population:
Pregnant women eligible for vaccination
Data Sources:
Primary Sense™, Clinical information systems
Contributors:
Practice Manager, GPs, Practice Nurses, Receptionists, GCPHN QI Project Officer
Year:
2021
Location:
Enfield, UK
Topic:
COVID-19 Vaccination for Children
Document Type:
Q&A Session Transcript
Organ/Institution:
Enfield Public Health, NHS
Authors:
Dudu Sher-Ami, Belinda Danso-Langley, Dr Ogechukwu Ilozue
Target Audience:
Parents and carers of 12–15-year-olds
Date of Event:
4th October 2021
Vaccination Age Group:
12–15 years
Delivery Method:
School-based clinics
Special Provisions:
Support for children with needle-phobia, learning difficulties, ASD, ADHD, and allergies
Contact:
[email protected], Tel: 0208 702 3324
Year:
2025
Region / City:
Eugene, Oregon
Subject:
Affordable Housing, Systems Development Charges, Low-Income Housing
Document Type:
Request for Proposals (RFP)
Agency / Institution:
City of Eugene
Author:
Laura Hammond, Community Development Division of the City of Eugene
Target Audience:
Public agencies, private/for-profit, and non-profit developers
Period of Validity:
FY 2026
Approval Date:
July 16, 2025
Amendment Date:
Not specified
Year:
N/A
Region / City:
Marysville, WA
Topic:
Property Tax Exemption, Industrial Manufacturing
Document Type:
Application Form
Organization / Institution:
Community Development Department
Author:
N/A
Target Audience:
Property owners, applicants for tax exemption
Effective Period:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Note:
Year
Year:
1999
Region / city:
New Zealand
Subject:
Risk management, animal products
Document type:
Legal
Organization / institution:
Ministry for Primary Industries (MPI)
Author:
Director-General
Target audience:
Producers, processors, risk management programme operators
Period of validity:
Indefinite
Approval date:
Not specified
Amendment date:
Not specified
Year:
2021
Region / City:
Kuala Lumpur
Subject:
Tax Exemption for Islamic Fund Management
Document Type:
Certification Form
Organization / Institution:
Securities Commission Malaysia
Author:
Securities Commission Malaysia
Target Audience:
Fund management companies in the Islamic fund management industry
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2018
Region / City:
California
Topic:
Tuition exemption
Document Type:
Application form
Institution:
California Colleges and Universities
Author:
California State Government
Target Audience:
Nonresident students applying for tuition exemption
Period of Validity:
Until eligibility requirements are no longer met
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2012
Region / city:
Australia
Subject:
Domestic commercial vessel survey and exemption
Document type:
Official form
Issuing organization:
Australian Maritime Safety Authority (AMSA)
Target audience:
Vessel owners, marine surveyors, national regulators
Validity period:
14 days from signature date
Date of approval:
Not specified
Date of modification:
Not specified
Year:
2019
Region / City:
San Francisco
Topic:
Surveillance Technology Ordinance
Document Type:
Ordinance
Organization:
San Francisco Board of Supervisors
Author:
San Francisco Board of Supervisors
Target Audience:
City departments, COIT staff
Period of Effect:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified