Clinical Rotation Exemptions

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Warning: Each exemption must be individualized and general advice on this page may not be applicable to your situation. Please also note that using templates or form letters can often result in a denial. Some schools and employers use AI to identify exemption requests that contain copied language and use this as a basis to argue the exemption is not sincere.

Siri & Glimstad is the leading national firm assisting individuals with vaccine exemptions. Allison R. Lucas, Esq., the head of the vaccine exemption practice, is literally the author of the authoritative book on vaccine exemptions and has assisted hundreds of individuals in obtaining exemptions, including complex situations. If you are looking for sophisticated assistance to provide the greatest odds of securing an exemption, we look forward to assisting you.

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Individualized Assistance with a Clinical Rotation Exemption

Typically, the most efficient and economical avenue to avoid a vaccine mandate is to obtain a religious or medical exemption. Our attorneys have helped numerous clinical rotation students obtain a vaccine exemption, even where the college or clinical rotation site asserts that no vaccine exemptions are available.

Religious exemptions are governed by the U.S. Constitution and any applicable state law. Religion is defined broadly under these laws, so you do not need to belong to any specific religion. Your affiliated religion does not have to be opposed to vaccination because it is your personal religious belief that matters.

Medical exemptions are governed by the Americans With Disabilities Act and any applicable state law. These laws encompass many conditions and are not limited to only those recognized by the CDC as a contraindication or precaution.

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We’ve Obtained Hundreds Of Student Exemptions

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Medical Exemptions to Vaccines FAQ

What is a valid medical vaccine exemption?

Generally, a valid medical exemption meets the requirements of the Americans with Disabilities Act. This means a treating healthcare professional writes it and describes a physical or mental impairment that substantially limits one or more major life activities or a record of such an impairment (i.e., a person may have a history of cancer or asthma, but it is in remission). Major life activities include walking, seeing, hearing, speaking, breathing, learning, working, caring for oneself, and performing manual tasks. The exemption must also explain why the protected condition makes receiving the vaccine or vaccines at issue more of a risk than a benefit.

Can a college or clinical rotation site deny a vaccine exemption if it doesn’t meet the CDC’s definition of contraindication or precaution?

The Americans with Disabilities Act (ADA) requires that covered entities accommodate program participants who meet the legal requirements of this federal statute, assuming that they can do so without undue hardship. The ADA’s definition of “disability” is written very broadly. The purpose and intent of the ADA and the case law involving the ADA do not support the idea that a covered institution can limit the protection of the ADA to such narrow confines.

What law governs vaccine exemptions?

Generally, vaccine exemptions for college and clinical rotation students are regulated by the Americans with Disabilities Act and any similar state law. The ADA may not apply to a private religious institution, but there are instances when the institution voluntarily adheres to it. The applicability of these disability rights laws is contingent upon the specific circumstances and the types of institutions and disabilities covered by the statutes.

What if my healthcare provider will not write an exemption for me?

Sometimes, a healthcare provider will not write a vaccine exemption, even if they believe vaccination is unsafe for their patient, simply because they don’t know how or what conditions legally qualify. Siri & Glimstad attorneys often work with clients and physicians to develop legally sound language based on the client’s medical history and diagnosis.

What if my college or clinical rotation site states that medical exemptions are not permitted for students in my program?

Entities covered by the Americans with Disabilities Act must accept an application for a medical vaccine exemption. However, the institution can deny the request if it doesn’t meet the law’s requirements or if it can prove that providing the exemption poses an undue hardship. Regarding a vaccine exemption, an undue hardship usually means that the entity alleges that permitting an unvaccinated person at the educational facility poses a risk of harm to others. Siri & Glimstad attorneys have assisted many clinical rotation students in obtaining a medical exemption where the college and/or rotation site stated that no exemptions were permitted.

My college or rotation site denied my request for a medical exemption based on “undue hardship.” What does that mean?

Regarding a vaccine exemption, an undue hardship usually means that the institution alleges that permitting an unvaccinated student on-site poses a risk of harm to others. However, the student will often have arguments to overcome this position. For example, if the vaccine or vaccines at issue don’t prevent transmission or infection, the arguments regarding undue hardship are not compelling. Siri & Glimstad’s managing partner, Aaron Siri, has several Substack articles regarding whether certain vaccines prevent infection or transmission of their targeted pathogen.

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Religious Exemptions to Vaccines FAQ

Does Title VII protect me as a clinical rotation student?

No. It’s a common misconception among clinical rotation students that they are definitely protected by the prohibition against religious discrimination in the workplace by Title VII of the Civil Rights Act of 1964 (Title VII). Unfortunately, while this federal law safeguards employees and job applicants from religious discrimination in the workplace, it may not cover independent contractors and non-paid individuals like volunteers or clinical rotation students. The good news is that other laws may offer protections, depending on the state and type of institution involved (i.e., private, public, or religious). Understanding these potential protections is crucial as a clinical rotation student.

Does the U.S. Constitution require the college and clinical rotation site to offer a religious vaccine exemption?

Public institutions are required to adhere to the U.S. Constitution. Recent cases have held that the First Amendment’s Free Exercise Clause requires that if a public institution offers a discretionary secular (medical) vaccine exemption, it must also provide an option for a religious exemption. This was clearly established in a Supreme Court case, Fulton v. City of Philadelphia, 141 S. Ct. 1868 (2021). In another case, Tandon v. Newsom, 141 S. Ct. 1294 (2021), the Supreme Court ruled that an institution undermines the neutrality and general applicability of a policy that doesn’t allow religious exemptions when it allows comparable secular activities. This means that if a public institution allows medical exemptions and other unvaccinated individuals in the hospital and patient setting, then a policy that categorically prohibits religious exemptions for clinical rotation students is likely unconstitutional. These cases are particularly relevant for clinical rotation students as they are often required to receive childhood vaccinations such as MMR, varicella, and polio. If these vaccines are not required for employees, then the policy is likely unconstitutional, according to the rulings in Fulton and Tandon. Similarly, if the clinical rotation student is mandated to receive the Tdap, flu, and COVID-19 vaccines, but hospital employees are regularly exempted from these requirements, the policy is likely unconstitutional under these U.S. Supreme Court cases.

If my college or rotation site is a private institution, is it pointless to request a religious exemption if the college states it won’t accept it?

While the U.S. Constitution doesn’t apply to private colleges or medical facilities, other arguments are available. For example, it may be fruitful to present some of the following arguments, depending on the facts, circumstances, and applicable state law, with regard to the institution’s vaccine mandate and/or denial of a religious exemption:

  • Breach of contract, including of the implied covenant of good faith and fair dealing;
  • Violation of the institution’s mission statement, policies, or procedures regarding discrimination;
  • Violation of the institution’s accreditation requirements;
  • Contrary to local, state, or national health guidance;
  • Contrary to other local facilities’ policies;
  • Impermissible coercion and retaliation;
  • Contrary to published science or otherwise unscientific, for example, mandates for vaccines that do not prevent transmission of the targeted pathogen (COVID-19, IPV, Tdap, etc.); or
  • Violation of federal and state housing laws, such as the federal Fair Housing Act or California’s Fair Employment and Housing Act, if denial requires vacating student housing.

Critically, many of these arguments depend on the student submitting a robust and legally sound religious exemption request. Absent submitting a legally sound exemption, the grounds for most of the arguments listed above fall away because the student failed to meet the legal requirements for an exemption.

What is a valid religious exemption?

If a state statute governs, it will define what is required for a valid religious exemption. In the absence of a statute, the college will have a policy and procedure governing religious exemption. Public colleges and clinical sites are required to adhere to the U.S. Constitution regarding any religious exemption policies and procedures. Private institutions have a lot of leeway to set their policies regarding vaccination and exemptions. For example, at least one state appeals court has held that a private religious school does not have to provide a religious exemption to its vaccination requirement, even when a state statute provides the exemption.

When writing an exemption, it is essential to understand that the law regarding religious exemptions is complex and non-intuitive. Many people are denied an exemption simply because they used common sense and expected the employer, school, or clinical rotation site to do the same. Some of the basics regarding a religious exemption are summarized below.

Generally speaking, to qualify for a religious exemption to a vaccine mandate, the student must articulate a sincere religious belief that they hold, which prevents them from receiving the vaccine(s) at issue. Therefore, simply reciting statements such as, “I have sincere religious beliefs against vaccination” is generally insufficient.

  • In most instances, institutions can question the sincerity or the religious nature of the beliefs.
  • The terms “sincere” and “religious” are what the legal profession calls “terms of art,” meaning they don’t have the ordinary meaning that most people would ascribe to them. These terms are defined by case law.
  • The student must clearly explain why their religious beliefs prevent vaccination with each vaccine that is mandated. Simply reciting religious beliefs is not sufficient.
  • Whether the student qualifies for the religious exemption is not a theology question. It is a legal question and must meet legal strictures. The student can have a deeply held belief, but if the student presents the beliefs in a way that violates the “rules” for what is considered a valid religious exemption, it may get denied.
  • Legal arguments or citations should never appear in a statement describing religious beliefs or in an application for religious accommodation.
Can a private religious college deny my religious exemption?

At least one state appeals court has held that a private religious school does not have to provide a religious exemption to its vaccination requirement, even when a state statute provides the exemption.

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More Information: Clinical Rotation Exemptions

Requirements for clinical rotation student exemptions vary, but almost every college and clinical site is required to accept a request for a medical exemption. Medical exemptions are based on the student’s medical history and must be written by a healthcare professional. Often, these exemptions must be worded in a particular way to meet the requirements of the law. We regularly work with healthcare professionals and negotiate with college administrators and attorneys to have valid medical exemptions approved.

Whether a college or clinical site has to accept a request for a religious exemption depends on several factors. Typically, students submit a “statement of belief” that describes their religious beliefs and practices to apply. However, colleges and clinical rotation sites are allowed to reject a religious exemption if it does not meet certain legal criteria.

Through personal representation, we can help you avoid common pitfalls when submitting a medical or religious exemption for a program that requires a clinical rotation. We have assisted many clinical rotation students across the country in obtaining a vaccine exemption.

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Meet Allison R. Lucas,
Head of Vaccine Exemptions


Your Vaccine Exemption Team

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Allison R. Lucas
Location: Detroit
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Walker Moller
Location: Austin, TX and Jackson, MS
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Christina Xenides
Location: Austin
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Catherine Cline
Location: Miami
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Wendy Cox
Location: Austin
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Marc Dudley
Location: New York
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Gina Mannella
Location: Chicago

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