To be eligible for a possible exception, you must first establish that your refusal to be vaccinated is based upon a sincere belief that is religious in nature. Show proof of their child's up-to-date vaccinations, OR; Provide a valid medical exemption from vaccination.The template allows employees to request an exemption from an employee vaccination mandate and provide corroborating information and documentation. Fill out the information below to receive access to the sample Vaccine Exemption Request Template. Name(required). In order to request a religious exception, please fill out this form.