Student Mask, Vaccination, and/or Rapid Testing Exemption Application

Updated: September 10, 2021

Starting September 1, 2021, among other Safety Measures General Directives (herein the ‘directives’),

  • all individuals coming to the University of Alberta (herein ‘the University’) campuses are required to be fully vaccinated against COVID-19 or undergo regular rapid testing for COVID-19. To comply with the directives, students, faculty, and staff need to confidentially self-declare their vaccination status before coming to campus. Those who are not fully vaccinated, and those who would prefer not to disclose their vaccine status, will need to regularly complete a rapid screening test and receive a negative result before they participate in in-person activities.
  • the University requires that all faculty, staff, students and visitors to all U of A campuses wear non-medical face masks (masks) at all times in all university indoor common-use spaces — on its property, vehicles and leased spaces.

For additional information, review full details about the directives for declaring vaccination status and rapid testing and non-medical masks on campus, as well as the General Safety Measures Directives.

The university will take steps to accommodate individuals who are not able to comply with the Directives on the basis of a protected ground under the University’s Discrimination, Harassment and Duty to Accommodate Policy. Students who believe that they are not able to comply on the basis of a protected ground must apply for an exemption, including supporting documentation. In addition, individuals may be exempt from the non-medical masks directive when they are:

  • Under the age of 2;
  • Unable to place, use, or remove a mask without assistance;
  • Providing care or assistance to someone with a disability where a mask would hinder that caregiving or assistance.

Any student who wishes to apply for an exemption from the rapid testing, vaccination, or non-medical masking directives must complete the Student Mask, Vaccination, and/or Rapid Testing Exemption Application Form. Students approved for exemptions from the directives will be notified by email and are advised to save the email notification in order that they may provide the email notification as proof of the exemption.

If you have questions or require assistance, please email dosdean@ualberta.ca.  

PLEASE NOTE: University of Alberta faculty or staff members who wish to apply for exemptions to any general safety measures directives should consult the Safety Measures General Directives.

Required Exemption Application Supporting Information & Documentation

To apply for an exemption to the directives, students must provide the following information in their applications:

    • to apply based on physical or mental disability (i.e., medical concern or limitation) as a protected ground under the University’s Discrimination, Harassment and Duty to Accommodate Policy, students must provide objective medical documentation (completed by a qualified healthcare practitioner) that explains in detail 
      • the medical basis on which they cannot be fully vaccinated against COVID-19 and/or tested for COVID-19 and/or wear a non-medical mask.
      • how long the student has had the medical condition(s) that is the basis of the application.
      • any other relevant information.
    • to apply based on religious belief as a protected ground under the University’s Discrimination, Harassment and Duty to Accommodate Policy, students must provide documentation (completed by a faith group/religious leader) that explains in detail
      • the basis of the applicant’s faith/religious beliefs which are contrary to being vaccinated against COVID-19 and/or tested for COVID-19 and/or wear a non-medical mask.
      • How long the applicant has been a member of the faith group/religion.
      • Any other relevant information.
    • to apply based on any other protected ground under the University’s Discrimination, Harassment and Duty to Accommodate Policy, students must explain in detail
      • the protected ground on which their application is based.
      • how and why this protected ground makes them unable to be vaccinated against COVID-19 and/or tested for COVID-19 and/or wear a non-medical mask.
      • any other relevant information.
  • to apply for an exemption from the non-medical mask directive on the basis that they need to provide care or assistance to someone with a disability where a mask would hinder that caregiving or assistance, students must explain in detail
      • their relationship to the individual(s) to whom they are providing assistance or care (e.g., parent, caregiver of sibling or parent, caregiver of friend, paid personal care attendant provider).
      • how and why the assistance they provide hinders the use of a non-medical mask. 
      • any other relevant information.
  • to apply for an exemption from the non-medical mask directive on the basis that they are unable to place, use, or remove a mask without assistance, students must explain in detail
    • the condition that makes them unable to place, use, or remove a mask without assistance.
    • how and why they are not able to place, use, or remove a non-medical mask without assistance.
    • any other relevant information.
Application Instructions

If you need to access the form in an alternate format or have questions, please email dosdean@ualberta.ca.

To complete the Student Mask, Vaccination, and/or Rapid Testing Exemption Application Form, 

  • Review the Required Exemption Application Supporting Information & Documentation and, if applicable, prepare your documentation before completing the form.
    • Any supporting documentation must be submitted as a PDF. If you do not have a scanner or cannot access electronic copies of your documentation, you can use a smartphone to take a picture of each individual page of your documentation and convert the images into a PDF document using applications/programs such as Adobe, iScanner, or Cam Scanner.
    • Use the following format to name all PDFs: last name_first initial_yyyymmdd (e.g., Smith_J_20200125). Important note: use the date on which the documentation was completed (as listed on the documentation) in the file name.
  • You will need to provide your University of Alberta Campus Computing ID (CCID) and Student ID Number.
  • Plan to spend about 5 to 10 minutes completing the form.
  • Remember to click the SUBMIT button at the end of the form to submit your form.

A copy of your completed form will be automatically emailed to you. Please check your University of Alberta email account regularly for communications about your application.

Complete the Application

Access the Student Mask, Vaccination, and/or Rapid Testing Exemption Application

Please note that you are NOT approved for an exemption from the directives until you receive email notification of your exemption approval. Students approved for exemptions from the directives will be notified by email and are advised to save the email notification in order that they may provide the email notification as proof of the exemption.

Important Student Mask, Vaccination, and/or Rapid Testing Exemption Guidelines
  • All components of the Student Mask, Vaccination, and/or Rapid Testing Exemption Application (including information submitted in this form) are subject to the policies and regulations of the University, including the University Code of Student Behaviour. 
  • Requests for exemptions will be considered upon submission of a complete Student Mask, Vaccination, and/or Rapid Testing Exemption Application form. 
  • Incomplete applications will not be reviewed.
  • Application supporting documentation must be completed in English or French.
  • Students are not approved for an exemption until they receive written notification of approval through their University email account. 
  • The University reserves the right to make appropriate inquiries to verify the authenticity of applications, including review by applicable medical specialists for applications based on medical protected grounds under the University's Discrimination, Harassment or Duty to Accommodate Policy or consultation with applicable specialists for applications made on other protected grounds under the University's Discrimination, Harassment or Duty to Accommodate Policy. The University may require that a student applying for an exemption provide additional information in order to consider and decide on a request. 
  • The duration of the exemption is at the sole determination of the University. Students approved for an exemption may request an extension to the exemption duration, if required.
  • Where students are approved for exemptions, the University will make efforts to reasonably accommodate. As part of a reasonable accommodation plan, students may be required to comply with other measures, modifications, or adjustments, or conditions may be required in order to protect the health and safety of the university community. To continue to protect the health and safety of the campus community, at the sole discretion of the University, students approved for exemptions to the directives may be accommodated through measures other than being granted access to campus.
  • Decisions may be appealed using the process outlined in the University’s Duty to Accommodate Procedure.
  • Students are permitted to reapply if new documentation and/or information becomes available, but students are responsible for ensuring that they provide all available, relevant information at the time of application.
  • Approved exemptions apply only to requests for exemption from the University’s directives. If you are seeking accommodations for other purposes, you will be required to make a separate application in accordance with existing accommodation registration procedures. If you have a previously approved accommodation, you must still submit the Student Mask, Vaccination, and/or Rapid Testing Exemption Application Form if you wish to be considered for an exemption from the directives.
  • Students approved for exemptions from the directives will be notified by email and are advised to save the email notification in order that they may provide the email notification as proof of the exemption.
Privacy Notice

The personal information you provide in the Student Mask, Vaccination, and/or Rapid Testing Exemption Application is confidential. 

The personal information requested is collected under the authority of Section 33(c) of the Alberta Freedom of Information and Protection of Privacy (FOIPP) Act and will be protected under Part 2 of that Act. It will be used for registration and administrative purposes in the above program offered by the University of Alberta Office of the Dean of Students. This information may be shared as needed to facilitate your exemption with other University of Alberta faculties, departments, or units. For further information, contact Dr. Mebbie Bell, Manager, Universal Design and Accessibility Facilitation c/o: 5-02 Students' Union Building, Edmonton, Alberta, T6G 2J7; phone: 780-492-4145; email: dosdean@ualberta.ca.