COVID-19 Immunization Medical Exemption Request Form

Instructions:

Morningside Students: Please complete this form and submit, with all required documentation, via the Columbia Health Patient Portal.

  1. Go to secure.health.columbia.edu and log in with your UNI.
     
  2. Select "Medical Clearances" from the left-hand menu.
     
  3. Select "Update" next to Immunization Record.
     
  4. Select "Upload" and attach the form and required documentation. Accepted formats are gif, jpg, png, and pdf. There is a 4 MB file size limit
     
  5. If the item is legible, click the "Looks Good" button; then click the "Save" button.
     
  6. After you upload and submit your entry, the University will review your request. Allow at least 15 business days for processing.

CUIMC Students: Please complete this form and submit, with all required documentation, via the Student Health on Haven Patient Portal.

  1. Read the pre-registration instructions requirements.
     
  2. Go to portal.studenthealth.cuimc.columbia.edu and log in with your UNI.
     
  3. Follow the instructions on the portal. Note that this immunization documentation is not listed on the current pre-registration forms.

Faculty and Staff: Please complete this form and submit, with all required documentation, to leavemanagement@columbia.edu.

 

Download the form: