Medical Exemption                                                        

Upon receiving Medical Exemption Form, the applicant should complete Section I and IV and then return to Committee Chairman:

                                                                Anita Evans

                                                                143 Karla Lane

                                                                Lafollette, TN 37766

Upon receiving the Medical Exemption Request Form, the medical exemption committee will complete the remaining steps of the process as outlined by NHPA and provide the applicant an answer of acceptance or denial within a period of thirty (30) days.

A medical examination by the treating physician should have been within a year of this request or sooner.

Keep section V and I would make a copy of page 1 once completed for your records  before sending the request to the committee chairman.