318-240-8766
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COVID-19 vaccine religious exemption request

  • To request an exemption from the COVID-19 vaccination due to a sincerely held religious belief, please fill out this form. This information will be used by Human Resources or other appropriate personnel to engage in an interactive process to determine eligibly for and to identify possible accommodations. If an employee refuses to provide such information or engage in the interactive process, the employee’s refusal may impact the Company’s ability to adequately understand the employee’s request or effectively engage in the interactive process to identify possible accommodations.

    If you are a member of a union, please consult with your Human Resources Department or union steward to inquire if there is a union specific form to complete.




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USI Industrial Services

4266 Hwy 1
Marksville, LA 71351
318-240-8766 Office
318-240-8769 Fax

Our Services

Turnkey Plant Turnarounds
Planning and Scheduling
Piping
Delta Valve Installation
Process Column Revamps
Specialty Welding
Turnkey Exchangers
Coker Unit Outages
FCCU Outages

USI Industrial
©MDU RESOURCES GROUP, INC.
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