Proof of COVID-19 Vaccination Form

The proof of vaccination will not be stored once it is reviewed by Urban staff. We will record that you are fully vaccinated and are allowed to attend on-campus events without proof of a recent negative COVID-19 test.

Proof of COVID-19 vaccine options include your vaccine card image (jpg, png, etc), California Immunization Registry record (pdf), or your California Digital COVID-19 Vaccine Record screenshot/QR code image.

For questions or assistance, please contact Office & Logistics Manager Drea Scally.