Request for Religious Waiver

This request form should be used when requesting a waiver for the meningitis vaccination for religious reasons.

Step 1 - Review and acknowledge the information below.
Step 2- Upload and submit your signed and notarized Meningitis Requirement Waiver.

To request disability accommodations for completing the request process, please contact the Disability Resource Center at DRC@MissouriState.edu or 417-836-4192.

1Review and Acknowlege the Information Below > 2Upload Notarized Form and Submit Form
Understanding the Requirements and Information
I have read the Missouri Department of Health and Senior Services Bureau of Immunizations Meningococcal Disease Fact Sheet.
I Understand that Missouri law requires all students residing in on-campus housing and off-campus fraternity and sorority housing, receive the meningococcal vaccination.
I understand that according, to the Missouri Department of Health and Senior Services Bureau of Immunizations, the best way to reduce the risk of getting meningococcal disease is through immunization.
Download the Meningitis Requirement Waiver on the next page. You can save your progress and return to this process to complete your request.
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Request for Religious Waiver

Request for Religious Waiver

Understanding the Requirements and Information

Download the Meningitis Requirement Waiver on the next page. You can save your progress and return to this process to complete your request.