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Proof of Vaccination

Collect proof of vaccination to ensure a safer return to work and protect the health and safety of all on-site employees, contractors, and visitors.

HealthcareProof of Vaccination
Proof of VaccinationHealthcareProof of Vaccination
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Edit the JSON below to fill in the Proof of Vaccination formEdit the JSON below to fill in the Proof of Vaccination form and download the completed PDF.

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What is the COVID-19 Proof of Vaccination form?

The purpose of this form template is to help organizations take steps to prevent the spread of COVID-19 in the workplace and to protect the health and safety of all on-site employees, contractors, and visitors.

Accompanying state or federal issued identification, valid forms of vaccination proof include:

  • Original, copy, or electronic photo of the CDC vaccination card (or similar documentation issued by another foreign governmental jurisdiction); or
  • Documentation from a healthcare provider; or
  • Personal digital COVID-19 vaccine record issued by another State, local, or foreign governmental jurisdictions; or
  • Personal digital COVID-19 vaccine record issued by an approved private company.

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