US COVID-19 Vaccine Exemption Letter

I, _________________________, declare religious exemption from the COVID-19 vaccination mandate. Under Title VII of the Civil Rights Act of 1964, I attest to having sincerely held personal religious beliefs which will not permit me to abide by this mandate. Additionally, I am not willing to describe these personal religious beliefs for the reasonable fear that if others have knowledge of them it may engender discrimination against me and/or my family.

I am aware that reasonable accommodations may have to be made regarding this declaration of religious exemption, and am willing to discuss accommodations that would be necessary and reasonable in order to come to an agreement. I will finally also expect this letter to remain confidential, and its contents to only be known to those for whom there is an express need.