SY 2021-2022 Medical Exemption Admin User Identification

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Please use this form to submit the names and email addresses for your Admin users that will be assigned to approve or deny exempted absence dates based on criteria outlined in OAC 210:10-13-25. If you plan to have more than one Admin Users, please submit multiple forms.

Medical exemption roles and responsibilities

Please provide the name of the District/Site for which you are submitting this form *

Admin User

This user reviews and approves medical exemption request (must be a different user than the Site user submitting the request). The site will not be able to approve requests unless this role is assigned.

Please provide the name of your Admin User that will be approving or denying requests submitted by the District/Site user. Note: the Admin user must be different than the District/Site user. *

Please provide Admin User's email *

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