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Alternative to Mandatory COVID-19 Testing Request Form

Students may request an exemption from the assigned testing date for any of the reasons cited below by sending this completed form to University Health Services (  If reason is health-related (indicated below by asterisk), submit this completed form along with healthcare provider’s note or laboratory report that substantiates your medical reason for the exemption request.  The form must be submitted within one week of the student’s receiving notification of required testing.

Please allow up to 72 hours for processing of any exemption request. 

This request is based on the following reason(s):

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Contact Us

University Health Services

Richard E. Lindner Center
2751 O'Varsity Way, 3rd Floor
Cincinnati, OH 45221-0010

Mail Location: 0769
Phone: 513-556-2564
Fax: 513-556-1337