Skip to Content

Los Rios Community College District has a process in place for any employee to request a medical exemption or religious exemption to the vaccination requirement.

Exemptions to the vaccination requirement are very limited and only available for certain medical conditions and sincerely held religious beliefs.

Request a Medical Exemption

To request a temporary or permanent medical exemption, a student must complete all of the following steps:

Complete Medical Exemption Form

Complete the Employee Medical Exemption Form, which includes two sections:

  1. The employee fills out section 1.
  2. A licensed physician fills out section 2.

Get Written Statement from Medical Provider

Provide a written statement from a medical provider exempting you due to a disability or serious medical condition. The statement must:

  • Be submitted on the doctor's office letterhead
  • Contain the doctor's printed name
  • Contain the doctor's license number
  • Contain the doctor's signature
  • Contain the date the statement is issued
Graphic of a checklist on a clipboard with five items

Log in to Employee Self-Service

Log in to Employee Self-Service and select COVID-19 Vaccination Status.

Screenshot of Employee Self-Service dashboard with COVID-19 Vaccination Status tile highlighted

Report Your Vaccination Status

  1. Under Report My Vaccination Status, select "I am NOT vaccinated."
  2. Toggle the button to Yes to indicate you have read and agreed to the statement.
  3. Click Submit.
Screenshot of Employee Self-Service Vaccination page with radio button checked next to non-vaccinated option

Review Instructions

  1. Navigate to Request COVID-19 Exemption under COVID-19 Vaccination Exemption.
  2. Review the instructions, then click Proceed with Exemption Request.
Screenshot of Employee Self-Service Exemption Instructions page

Select Supervisor and Exemption Type

  1. Click on the Supervisor ID field to select your supervisor.
  2. Select Medical Exemption under the Exemption Type drop-down.
Screenshot of Employee Self-Service Exemption Request page with Supervisor and Exemption Type fields highlighted

Enter Medical Information and Upload Attachment(s)

  1. Enter your physician's name and phone number.
  2. Upload the Student Medical Exemption Form completed by your physician (see step 1).
  3. Upload the written statement from your medical provider (see step 1).
  4. Review the acknowledgment and click to toggle the button to Yes.
  5. Click Submit.
Screenshot of Employee Self-Service Medical Exemption Request page

Check Email/Confirm Status of Request

After you submit your exemption request, you will receive an email confirming your submission has been received and is awaiting review.

You can check the status of your request in Employee Self-Service. To do this:

  1. Log in to Employee Self-Service.
  2. Select COVID-19 Vaccination Status.
  3. Select View COVID-19 Exemption under COVID-19 Vaccination Exemption.
  4. Use the Form ID (in your confirmation email), Form Type, or Student (or Employee) ID to search for your submitted exemption request.
Screenshot of Employee Self-Service View Exemptions page

After Exemption Approval, Submit Final Agreement in Employee Self-Service

You will receive an email notifying you if your request is approved or denied. If it is approved, then you need to log in to Employee Self-Service and take one last action to finalize your exemption agreement.

  1. Log in to Employee Self-Service.
  2. Select COVID-19 Vaccination Status.
  3. Select COVID-19 Exemption Agreement under COVID-19 Vaccination Exemption.
  4. Use the Form ID (in your confirmation email), Form Type, or Student (or Employee) ID to search for your exemption.
  5. Acknowledge all Action Items by toggling the button to Yes.
  6. Click I Agree to finalize your exemption agreement.
Screenshot of Employee Self-Service Exemption Agreement page

Request a Religious Exemption

To request an exemption based on sincerely held religious beliefs, a student must complete all of the following steps:

Log in to Employee Self-Service

Log in to Employee Self-Service and select COVID-19 Vaccination Status.

Screenshot of Employee Self-Service dashboard with COVID-19 Vaccination Status tile highlighted

Report Your Vaccination Status

  1. Under Report My Vaccination Status, select "I am NOT vaccinated."
  2. Toggle the button to Yes to indicate you have read and agreed to the statement.
  3. Click Submit.
Screenshot of Employee Self-Service Vaccination page with radio button checked next to non-vaccinated option

Review Instructions

  1. Navigate to Request COVID-19 Exemption under COVID-19 Vaccination Exemption.
  2. Review the instructions, then click Proceed with Exemption Request.
Screenshot of Employee Self-Service Exemption Instructions page

Select Supervisor and Exemption Type

  1. Click on the Supervisor ID field to select your supervisor.
  2. Select Religious Exemption under the Exemption Type drop-down.
Screenshot of Employee Self-Service Exemption Request page with Supervisor and Exemption Type fields highlighted

Enter General Position and Worksite Information

In General Position and Worksite Information, select all options that apply to you to mark them as Yes. By default, they will remain No.

Screenshot of Employee Self-Service Religious Exemption Request page with worksite info fields highlighted

Enter Religious Descriptions

Respond to each question under Description of Religious Belief, Practice, or Observance. A response to each question is mandatory.

Screenshot of Employee Self-Service Religious Exemption Request page with description fields highlighted

Request Accommodation (If Needed)

Under Requested Accommodation, describe any special accommodation you are requesting. If you are not requesting an accommodation, then write "No" or "N/A."

Screenshot of Employee Self-Service Religious Exemption Request page with accommodation field highlighted

Acknowledge and Submit

  1. Review the acknowledgments and click to toggle the buttons to Yes.
  2. Click Submit.
Screenshot of Employee Self-Service Religious Exemption Request page with submit button highlighted

Check Email/Confirm Status of Request

After you submit your exemption request, you will receive an email confirming your submission has been received and is awaiting review.

You can check the status of your request in Employee Self-Service. To do this:

  1. Log in to Employee Self-Service.
  2. Select COVID-19 Vaccination Status.
  3. Select View COVID-19 Exemption under COVID-19 Vaccination Exemption.
  4. Use the Form ID (in your confirmation email), Form Type, or Student (or Employee) ID to search for your submitted exemption request.
Screenshot of Employee Self-Service View Exemptions page

After Exemption Approval, Submit Final Agreement in Employee Self-Service

You will receive an email notifying you if your request is approved or denied. If it is approved, then you need to log in to Employee Self-Service and take one last action to finalize your exemption agreement.

  1. Log in to Employee Self-Service.
  2. Select COVID-19 Vaccination Status.
  3. Select COVID-19 Exemption Agreement under COVID-19 Vaccination Exemption.
  4. Use the Form ID (in your confirmation email), Form Type, or Student (or Employee) ID to search for your exemption.
  5. Acknowledge all Action Items by toggling the button to Yes.
  6. Click I Agree to finalize your exemption agreement.
Screenshot of Employee Self-Service Exemption Agreement page