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Humanitarian Exception Request

Humanitarian Exception Request

Humanitarian exceptions to the vaccine requirement are processed by the U.S. Center for Disease Control.  You can submit your request to the U.S. Embassy in New Delhi by emailing IndiaCDCTravel@state.gov, and we will send it on to CDC for review.  Please cut and paste the below chart into your email and answer all the questions thoroughly. Incomplete responses will not be forwarded to CDC for consideration.

 Families wishing to travel together may submit a single application – but must include data for each intending traveler.

No. Question/Information Request Answer
1.

What type of Humanitarian Request or Emergency Request are you making?  (Please note there are only two types of requests – no other can be entertained)

·                     Exemption from predeparture testing requirement.

And/or

·                     Exception for requirement for proof of being fully vaccinated

 
2.

·                     Surname (as it appears on your passport)

·                     Given Name (as it appears on your passport)

·                     Passport Number

·                     Expiration date of current U.S. Visa

·                     Nationality

 
3. ·                     Cell phone number including country code and email address of passenger or head of household if family unit  
4.

Flight itinerary, including any connecting flights:

·                     Airline

·                     Flight#

·                     Departure airport and date of departure

·                     Arrival airport and date of arrival

If you have not yet reserved a flight, write “NA” in this box.

 
5.

Vaccination Status:

·                     Note if you are NOT Fully Vaccinated (including if you have only received 1 dose of a two-dose series) OR

·                     Note if you are Fully Vaccinated

o    Name of vaccine product (or products if a combination)

o    Date of first dose

o    Date of second dose (if a two-dose series)

o    Attach a PDF or JPEG of vaccination record

 
6. Purpose of travel to the United States.  Provide a brief explanation of why urgent travel is needed to maintain the health and safety of the passenger(s)  
7.

Brief justification for humanitarian exemption from testing requirement; e.g., no testing available where passenger is located

And/or

Brief justification for humanitarian or emergency exception from providing proof of being fully vaccinated; e.g., vaccine availability, passenger ineligible for vaccine at location, insufficient time to become fully vaccinated

 
8. Attach documentation to support justification noted in number 7 above.  
9. Information regarding any other solutions that were sought prior to application;  e.g., flight changes, testing en route, assistance in obtaining testing/vaccination, etc.  
10 Leave Blank  
11 Leave Blank  
12 Leave Blank  

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