Opt in to COVID-19 Vaccine Documentation Giveaway

If you do not have vaccine documentation to upload, but would still like to be eligible for this giveaway, please submit the below form.

Important: Completion of this form is not a substitute for compliance with applicable university policy.

Students will still need to upload exemption documentation to the Patient Portal. This form does not replace or opt you out of this requirement. This form ONLY qualifies you for giveaway drawings.

Employees are not required to submit exemption documentation, however, if you are selected as a winner, you will be asked to complete an exemption form in order to collect your award.

Do not submit this form if you have already or plan to submit your COVID-19 vaccination documentation. Doing so will not increase your odds of winning a giveaway.