URGENT: We Need Updates to your File Please fill out all sections to the best of your abilities. Name* First Last What is the status of your Religious Waiver:SelectApprovedDeniedPendingWhat is the status of your Medical Waiver:SelectApprovedDeniedPendingIf your Religious Waiver was denied, have you filed an appeal? Yes No Please submit any updated questionnaire forms or guidance from your Employer (Save files) Drop files here or Select files Max. file size: 50 MB. Have you been terminated from your current position or has your contract been cancelled due to non-vaccination?* Yes No Have you been the subject of any disciplinary action or adverse employment action due to non-vaccination?* Yes No Have you requested vaccination with Comirnaty and been informed it is unavailable but that you must still be vaccinated by the applicable deadlines?* Yes No Have you been directed that you must take an EUA (i.e., unlicensed) vaccine?* Yes No In a short paragraph below, please describe your current work conditions, i.e. how have your superiors treated you, how have your co-workers treated you, what has your family has been subjected to as it pertains to your non-vaccination status?*In a short paragraph below, please describe a brief personal history of your employment prior to Covid19 mandates, including performance records, accomplishments, working relationship with superiors, co-workers and others in your field?*In a short paragraph below, please describe how being unvaccinated affected your life overall, including personal relationships, mental or physical health and financial burdens?*
