RMP Reasons
Further explanation of reason(s) for denial: [select name="reason_non_response" value="|No Response: "][conditional field="reason_non_response" condition="(reason_non_response).isNot('')"]We made multiple requests for additional information from you to make a decision about your request for a Covid exemption, but never heard back from you. [/conditional] [select name="reason_anxiety" value="|Anxiety: "][conditional field="reason_anxiety" condition="(reason_anxiety).isNot('')"]You or your treating provider requested exemption on the basis of severe anxiety. It is understandable that many people feel anxiety about vaccinations. However, that does not meet criteria for exemption. The federal mandate for vaccination specifically applies to health care workers because a single health care worker who chooses to go unvaccinated can bring disease to hundreds of patients in a setting where they are at extremely high risk of dying (people receiving chemotherapy or recovering from surgery, for example). [/conditional] [select name="reason_other_vaccine_allergy" value="|Allergic reaction to other vaccine: "][conditional field="reason_other_vaccine_allergy" condition="(reason_other_vaccine_allergy).isNot('')"]You requested an exemption from the Covid vaccine on the basis of an allergy to some other vaccine(s). An allergic reaction to a different vaccine that shares no common ingredients does not increase risk to the Covid vaccine. If you have documentation from an allergist that verifies your sensitivities prevent you from receiving the Covid vaccine, that would definitely meet criteria for exemption. [/conditional] [select name="reason_blood_clot" value="|Blood Clot: "][conditional field="reason_blood_clot" condition="(reason_blood_clot).isNot('')"]You or your treating provider requested exemption on the basis of a personal or family history of blood clots, such as would cause DVT, Pulmonary Embolism, Stroke, or Heart Attack. Blood clots do not qualify for exemption because you can opt for one of the mRNA vaccines, which have never been proven to increase risk of blood clots. [/conditional] [select name="reason_antibodies" value="|Antibodies: "][conditional field="reason_antibodies" condition="(reason_antibodies).isNot('')"]You or your treating provider requested exemption because you have antibodies to Covid. A positive antibody means that you have had covid (and/or been vaccinated to it). It does NOT mean that you are immune to COVID-19. (As people who contract Covid for the second and third time will tell you.) At present, it is not certain if having these antibodies means that you are protected from future infections, or for how long the protection might last. [/conditional] [select name="reason_personal_preference" value="|My Choice: "][conditional field="reason_personal_preference" condition="(reason_personal_preference).isNot('')"]You or your treating provider requested exemption on the basis that it is your choice not to do so. You are absolutely correct. However, you are asking us for an exemption to the rule which requires one, and deciding to refuse vaccination does not meet criteria for such an exemption. But whether I can approve the exemption or not, your choices are your own. If you don't want to get vaccinated, then don't. [/conditional] [select name="reason_guillain_barre" value="|Guillain-Barre (paralysis): "][conditional field="reason_guillain_barre" condition="(reason_guillain_barre).isNot('')"]You or your treating provider requested exemption on the basis of a personal or family history of temporary paralysis, like that caused by Guillain-Barre Syndrome. If you developed that in response to a prior dose of any covid vaccine, you should not get another dose. Otherwise, you can safely receive the mRNA vaccines (but should avoid the Johnson & Johnson vaccine). [/conditional]
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Sandbox Metrics: Structured Data Index 1, 14 form elements, 7 boilerplate words, 7 drop downs, 7 conditionals, 7 total clicks
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