This page provides the link to the required forms and the submission process for a religious institution to obtain confirmation of exemption. You may be asked to talk about the nature of your.The University will grant exemption to the vaccine requirement when an individual's sincerely-held religious beliefs preclude vaccination. We've provided a request form template for you to download and fill out here. The statement must include the student's date of birth and the date of each immunization. VACCINATION EXEMPTION PURSUANT TO INDIANA CODE §20-34-3-2. The Medical Exemption Form must list the immunization exempted, the medical contraindication and the length of time the immunization is contraindicated.