To be eligible for this exemption, complete and submit both this form and a completed Religious Accommodation Certification Form. Please briefly explain how your sincerely held religious belief, practice, or observance conflicts with your getting a COVID-19 vaccine.The template allows employees to request an exemption from an employee vaccination mandate and provide corroborating information and documentation. Covenant Health School of Nursing will grant exemption to the vaccine requirement when an individual's sincerely held religious beliefs preclude vaccination. The employee must complete and sign the Request for Religious.