Who can approve exceptions?

Approval authority varies by policy and impact. Typically managers approve low-risk exceptions and compliance or an elevated authority approves anything affecting regulatory controls or high risk.

Is an eSignature legally valid?

Yes. Electronic signatures are enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA laws where adopted, provided intent, consent, attribution, and record retention requirements are met.

Do healthcare exceptions need extra steps?

Yes. If PHI is affected, include a HIPAA risk assessment and ensure any vendor or platform handling PHI has a signed BAA; retain records for six years per 45 CFR §164.530(j).

What if the form is incomplete?

Incomplete submissions should be returned to the requestor with a checklist of missing items; processing should pause until required fields and attachments are provided to avoid incorrect approvals.

Can exceptions be extended?

Extensions are permitted only with documented re-assessment and re-approval before expiry; maintain a clear trail showing why the extension was necessary and who authorized it.

How long must I keep approved forms?

Retention depends on the nature of the exception: general corporate records often keep forms seven years post-expiry, tax‑related records three years under IRC §6501(a), and HIPAA‑related records six years under 45 CFR §164.530(j).

Electronic Signature
Templates
Miscellaneous
Request Exception Form

Request Exception Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

REQUEST EXCEPTION FORM AND AGREEMENT

Request Information

Requester Name Organization

Contact Email:

Contact Phone:

Request Date:

Policy or Procedure Reference

Exception Type: Temporary Permanent

Proposed Effective Start:

Proposed Effective End:

Recitals

WHEREAS, Requester Name: , representing Organization: , seeks an exception to the Policy or Procedure referenced above for the limited purpose and duration described herein;

WHEREAS, the Approving Authority has the discretion to grant exceptions subject to terms and conditions intended to mitigate operational, legal, and financial risk;

WHEREAS, the parties agree that any granted exception shall be documented in writing and implemented only in accordance with this Agreement and any attached approvals or conditions.

Scope of Work

Describe requested exception, activities to be performed, and deliverables

Justification and Impact

Justification for exception Operational, Legal or Financial Impact (anticipated)

Payment Terms

If any fee or cost is associated with the exception, the Requester agrees to pay in accordance with the following terms.

Total Amount Payable Payment Schedule and Milestones

Late Fee (% per month):

Late Fee (flat):

Term and Termination

This Exception shall commence on Start Date: and shall expire on End Date: , unless earlier terminated in accordance with this section.

Either party may terminate this Exception for convenience by providing written notice at least days prior to the intended termination date. Material breach that remains uncured for 30 days following written notice shall be grounds for immediate termination.

Confidentiality

All non-public information exchanged in connection with this Exception shall be treated as Confidential Information. Each party shall: (a) hold such information in strict confidence; (b) not disclose it to third parties except as required by law or as necessary to perform its obligations hereunder; and (c) return or destroy such information upon expiration or termination of this Exception. Confidentiality obligations survive termination for a period of three years.

Requester acknowledges and agrees to the confidentiality terms above

Governing Law; Remedies

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to choice-of-law principles. Remedies shall be cumulative and in addition to any other rights available at law or in equity, including injunctive relief to prevent breach of confidentiality or unauthorized use.

Representations; Entire Agreement

Each party represents that it has full corporate or organizational power and authority to enter into this Agreement and to perform its obligations hereunder. This Agreement constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, proposals and communications, whether oral or written. No amendment shall be effective unless in writing and signed by both parties.

Approvals and Decision

Recommended decision by Reviewing Authority: Approve Deny

Approver Comments

Additional Terms

Requester:

By:

Date:

Approver:

By:

Date:

What the Request Exception Form Is and when it’s used

A Request Exception Form documents a formal request to deviate from a standard policy, requirement, or procedure and records the rationale, scope, and approvals for that deviation. Organizations use it to capture who requested the exception, the impacted processes or assets, the proposed mitigation, and the timebound period of the exception. The form functions as an auditable record for reviewers, compliance teams, and downstream owners, and typically accompanies supporting evidence such as risk assessments or manager approvals.

Why an organized exception record matters

A clear Request Exception Form creates a documented decision trail that helps manage risk, maintain regulatory compliance, and ensure consistent approval criteria. It reduces ambiguity during reviews and supports post‑approval audits by capturing required controls and expiration conditions in one place.

Who typically completes and reviews this form

Final signoffs usually come from the designated authority for the impacted control domain; the form should show who signed, the date, any conditions, and the expiry or review schedule.

Requestor: Project or process owner who describes the need and supplies supporting evidence in concise, factual terms.
Manager/Approver: Direct supervisor who confirms necessity and operational mitigations before forwarding to compliance.
Compliance/Risk Reviewer: Subject-matter reviewer who assesses legal, security, and policy implications and applies risk conditions.

Step-by-step: how to complete a Request Exception Form

Follow these sequential steps to ensure the request is complete, auditable, and reviewable by compliance and operational owners.

01

Prepare details: Describe the policy or control being excepted and the specific change requested.
02

State justification: Provide business reason, expected duration, and measurable impact.
03

Attach evidence: Add risk assessments, technical mitigations, and related approvals.
04

Obtain signoffs: Collect manager and compliance signatures with dates and expiry terms.

Typical digital workflow settings for online completion

Configure the form fields and routing rules to ensure consistent handling and automated notifications during review.

Field	Configuration
Required Fields	Requestor, Policy ID, Justification, Dates
Routing Order	Manager -> Compliance -> Risk -> Final Approver
Authentication	Email + optional SMS or SSO for higher assurance
Retention Tag	Apply compliance retention metadata upon approval

Digital and platform considerations for eSubmission

Ensure the platform meets your compliance needs (encryption in transit and at rest) and can export signed records for long‑term storage.

File formats: PDF, DOCX accepted
Audit trail: IP address, timestamp, action log
Integrations: SSO, MS 365, Google Workspace

How electronic submission and review typically flows

The following stages show a common end-to-end eSubmission path for a Request Exception Form.

Upload: Requestor uploads form and attachments.
Auto‑route: System routes to manager based on department.
Compliance review: Compliance assesses risk and adds conditions.
Final approval: Authorized approver signs and records expiry.

Typical timelines and target response windows

Set clear deadlines on the form to keep reviews timely and ensure exceptions do not remain open indefinitely.

Submission deadline:

Requestor should submit at least 5 business days before the desired effective date.

Acknowledgment:

System should send an acknowledgment within 24 hours of submission.

Manager review:

Manager decision targeted within 3 business days of receipt.

Compliance review:

Compliance completes risk assessment within 7 business days.

Final decision:

Final approval or denial issued within 10 business days, barring escalations.

Key milestones from request to closure

Track milestone dates to support audits and to trigger review actions when expiry approaches.

01

Request Submitted

Form filed and timestamped by the requestor.

02

Manager Approval

Manager verifies necessity and forwards to compliance.

03

Compliance Conditions

Compliance lists required mitigations or compensating controls.

04

Exception Expiry

Automatic reminder issued before expiry for reassessment.

Common mistakes to avoid when preparing the form

Omitting the specific policy reference causes reviewers to interpret the scope and often leads to denial or delay.
Using vague justifications like 'business need' without measurable impact or alternatives prevents objective risk assessment.
Failing to attach technical mitigations or temporary compensations forces compliance to assume higher risk and reject the request.
Not setting a clear expiry date allows exceptions to persist and creates audit and control gaps over time.

Potential consequences of incomplete or unauthorised exceptions

Operational Risk: Uncontrolled deviations increase incident exposure.

Compliance Violation: Regulatory noncompliance and enforcement risk.

Financial Penalty: Fines or remediation costs may apply.

Audit Finding: Negative audit results and remediation.

Revocation: Exception may be rescinded retroactively.

Reputational Harm: Stakeholder trust may be affected.

Essential sections every professional Request Exception Form should include

A robust form captures sufficient detail for reviewers and auditors while standardizing decisions across similar requests.

Request metadata

Fields for requestor name, department, submission date, and request identifier so records can be indexed and traced during review and audit.

Policy reference

Exact policy name and section number being excepted, plus a short description so reviewers immediately see the control context.

Scope and duration

Clear definition of systems, processes, or users affected and precise effective and expiry dates to avoid open-ended exceptions.

Business justification

Concise, quantified business reason explaining why the exception is necessary and why alternatives were not suitable.

Risk mitigations

Compensating controls, monitoring, or technical workarounds that will reduce the exposure while the exception is active.

Approval history

Signature blocks, role-based approvals, approval timestamps, and any conditional notes required for future audits.

Selected eSignature vendor comparison for submitting and approving Request Exception Forms

Basic pricing and feature indicators for common eSignature vendors are shown below; signNow is listed first per vendor comparison norms.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by region	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Practical configuration items for exception workflows

Configure these settings to support secure routing, conditional approvals, and archival of approved exceptions.

Field	Configuration
Approval tiers	Define thresholds and role order
Conditional fields	Display mitigation fields only if risk level high
Authentication	Enable SSO and two-factor for approvers
Retention policy	Auto-apply retention tag on final approval

Frequently asked questions about Request Exception Forms

Answers to common questions about completing, routing, and retaining a Request Exception Form in a compliant, auditable manner.

Need help? Contact support

Who can approve exceptions?
Approval authority varies by policy and impact. Typically managers approve low-risk exceptions and compliance or an elevated authority approves anything affecting regulatory controls or high risk.
Is an eSignature legally valid?
Yes. Electronic signatures are enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA laws where adopted, provided intent, consent, attribution, and record retention requirements are met.
Do healthcare exceptions need extra steps?
Yes. If PHI is affected, include a HIPAA risk assessment and ensure any vendor or platform handling PHI has a signed BAA; retain records for six years per 45 CFR §164.530(j).
What if the form is incomplete?
Incomplete submissions should be returned to the requestor with a checklist of missing items; processing should pause until required fields and attachments are provided to avoid incorrect approvals.
Can exceptions be extended?
Extensions are permitted only with documented re-assessment and re-approval before expiry; maintain a clear trail showing why the extension was necessary and who authorized it.
How long must I keep approved forms?
Retention depends on the nature of the exception: general corporate records often keep forms seven years post-expiry, tax‑related records three years under IRC §6501(a), and HIPAA‑related records six years under 45 CFR §164.530(j).

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now