Due to the COVID-19 pandemic and in compliance with the State of Utah Public Health Order, Jordan School District will require students to wear face coverings while at school.
Jordan School District recognizes that some students may have a medical condition, mental health condition, or disability that prevents wearing a face covering. In order to receive an exemption from the State’s face covering requirements, this form must be completed and returned to the school your child attends prior to your student attending school without a face covering.
Please have your primary care provider complete the Medical Certification by doing one of the following:
- Complete and sign the Medical Certification below.
- Attach an email or note from the primary care provider outlining the same information as indicated below to this completed form.