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Certification of Vaccination

Available Formats: PDF
Document Type: Forms.
Document Number: omb32060277

Public Comment: Instructions: Right-click on the PDF link and save this form to your computer. Open the form in Adobe Acrobat Reader or Pro to fill out and sign.

All IPAs, Fellows, contractors, and visitors must present a completed Certification of Vaccination Form upon entering the NSF building and carry it with them while in the building. The information on this form will be used to implement specific safety protocols for fully vaccinated individuals and not fully vaccinated individuals, respectively consistent with guidance from the Safer Federal Workforce Task Force and the Centers for Disease Control and Prevention (CDC).

Document History: Posted: June 2, 2022.

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