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COVID-19 CONTRACTOR NOTIFICATION & CERTIFICATIONCOVID19 VACCINATIONS OF COUNTY CONTRACTOR PERSONNEL You are receiving this notice because the County of Los Angeles (County) has identified you or your
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How to fill out self-certification of vaccination status
How to fill out self-certification of vaccination status
01
Obtain a self-certification form for vaccination status from your employer or the appropriate authority.
02
Fill out your personal information such as name, date of birth, and contact details.
03
Provide details of your vaccination record, including the type of vaccine received, dates of vaccination, and the administering authority.
04
If required, attach supporting documents such as vaccination cards or certificates.
05
Sign and date the self-certification form to affirm the accuracy of the information provided.
06
Submit the completed self-certification form to your employer or the appropriate authority as per their instructions.
Who needs self-certification of vaccination status?
01
Individuals who have been vaccinated and need to provide proof of their vaccination status typically require a self-certification of vaccination status. This may include employees returning to work, individuals participating in certain events or activities, and travelers crossing international borders among others.
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What is self-certification of vaccination status?
Self-certification of vaccination status is a process where individuals confirm their vaccination status without the need for external verification.
Who is required to file self-certification of vaccination status?
All individuals who are mandated to be vaccinated and required to provide proof of vaccination status.
How to fill out self-certification of vaccination status?
Individuals can fill out self-certification forms provided by their employers or relevant authorities, confirming their vaccination status.
What is the purpose of self-certification of vaccination status?
The purpose of self-certification of vaccination status is to ensure compliance with vaccination requirements and provide a way for individuals to confirm their vaccination status.
What information must be reported on self-certification of vaccination status?
Information such as the name of the individual, date of vaccination, type of vaccine received, and any relevant vaccination dates.
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