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Attachment 3HAWAII HEALTH SYSTEMS CORPORATION (HHSC) Request for Religious Exemption from Mandatory COVID-19 Vaccination & Reasonable Accommodations Request Form Please initial each statement: ___

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How to fill out covid-19 vaccination attestation form

01

Obtain a copy of the covid-19 vaccination attestation form from the relevant healthcare authority.

02

Fill in your personal details such as name, date of birth, and contact information.

03

Indicate whether you have received the covid-19 vaccine and provide details such as the type of vaccine and date of vaccination.

04

Sign and date the form to confirm the information provided is accurate.

05

Submit the completed form to the appropriate healthcare provider or organization as required.

Who needs covid-19 vaccination attestation form?

01

Individuals who have received the covid-19 vaccine and need to provide proof of vaccination for travel, work, or other purposes.

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What is covid-19 vaccination attestation form?

The Covid-19 vaccination attestation form is a document where individuals can confirm and provide proof of their Covid-19 vaccination status.

Who is required to file covid-19 vaccination attestation form?

Individuals who are required to provide proof of their Covid-19 vaccination status may be required to file the Covid-19 vaccination attestation form.

How to fill out covid-19 vaccination attestation form?

To fill out the Covid-19 vaccination attestation form, individuals need to provide their personal information, vaccination details, and sign the form to confirm the accuracy of the information provided.

What is the purpose of covid-19 vaccination attestation form?

The purpose of the Covid-19 vaccination attestation form is to verify and document an individual's Covid-19 vaccination status for various purposes such as travel, employment, or access to certain venues.

What information must be reported on covid-19 vaccination attestation form?

The information typically required on the Covid-19 vaccination attestation form includes personal details, vaccination date(s), vaccine type(s), and any supporting documentation.

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