I verify that the information I am submitting to substantiate my request for exemption from OCC’s vaccination/mask policy is true and accurate to the best of my knowledge. I understand that any falsified information can lead to disciplinary action, up to and including termination.

I further understand that OCC is not required to provide this exemption accommodation if doing so would pose a direct threat to myself or others in the workplace or would create an undue hardship for OCC.

After pressing submit you will be provided with a pdf. This can be printed or emailed, but the second section must be filled out by your physician and returned to your manager or division leader.