Request for Exemption for Wearing a Mask
Complete this form to request approval for an exemption for wearing a mask in school. The Tri-County Public Health Order specifically states that exemptions may only be granted if a student is unable to medically tolerate a face covering. Following submission of this form, you will be notified if your request has been approved.
Documentation must include 1) Medical provider’s printed name, license number, address, phone number on the provider's letterhead (not prescription pad) 2) Signature of the medical provider and 3) Identification of the medical condition preventing the individual from wearing a mask and any recommended alternative to the mask.