Proof of COVID-19 Vaccination Form

Your proof of vaccination information will not be stored once it is reviewed by Urban staff. We will record that you are fully up to date or 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 email