VA Form 10-263 Printable, Fillable in PDF

VA Form 10-263 Printable, Fillable in PDF – The Veterans Health Administration has ordered that all Title 38 workers get immunized. There are, however, certain exceptions. A request for an exemption based on the exclusion criteria for medical or religious reasons may be made by any employee, and the procedure is the same as for the flu vaccination.

VA Form 10-263 Printable, Fillable in PDF

Instructions For Completing VA Form 10-263

Filling out VA Form 10-263 is simple if you follow these steps:

  • VA Form 10-263 (Appendix B) stating an exemption for medical contraindications should be completed by a personal physician signature and their National Provider Identification number, which should be included on the Covid Vaccination Form VA Form 10-263 (Appendix B). The contraindication must be recognized by the Centers for Disease Control and Prevention.  Employees working for the VHA under Title 38 must acquire their immediate supervisor’s signature without revealing the medical cause for their absence. A completed VA Form 10-263 (Appendix B) must be submitted to the Employee Occupational Health staff within eight weeks following the publication of the form by the employee.
  • Exemption based on religion To request an exemption from the COVID-19 vaccination because of a firmly held religious conviction, a Title 38 employee must submit the COVID-19 Vaccination VA Form 10-263 (Appendix B), which declares their religious belief as to the reason for their refusal to be immunized. The Title 38 employee must request approval from their supervisor on the VA Form 10-263 (Appendix B) as soon as possible without revealing the religious cause for their absence. A completed VA Form 10-263 (Appendix B) must be submitted to the Employee Occupational Health staff within eight weeks following the publication of the form by the employee.

VA Form 10-263 Printable, Fillable in PDF

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