Form preview

Get the free Employee Attestation of Covid-19 Vaccination template

Get Form
I, (print name)___ attest that I am (check one box indicating current status) ? fully vaccinated ? partially vaccinated against COVID19 and that I am unable to provide documentation as proof of my
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign employee attestation of covid-19

Edit
Edit your employee attestation of covid-19 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your employee attestation of covid-19 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing employee attestation of covid-19 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Here are the steps you need to follow to get started with our professional PDF editor:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit employee attestation of covid-19. Replace text, adding objects, rearranging pages, and more. Then select the Documents tab to combine, divide, lock or unlock the file.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
With pdfFiller, it's always easy to work with documents. Try it out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out employee attestation of covid-19

Illustration

How to fill out employee attestation of covid-19

01
Step 1: Begin by downloading the employee attestation of covid-19 form from your company's website or HR department.
02
Step 2: Read the instructions carefully and gather all the necessary information before filling out the form.
03
Step 3: Fill in the employee's personal details such as name, employee ID, and contact information.
04
Step 4: Indicate the date and time of the employee's entry to work and the location of the workplace.
05
Step 5: Answer the self-declaration questions regarding the employee's health condition and potential exposure to COVID-19.
06
Step 6: Provide any additional information or comments if required.
07
Step 7: Sign and date the attestation form.
08
Step 8: Submit the completed form through the designated method instructed by your company, such as email or online form submission.
09
Step 9: Keep a copy of the filled-out attestation form for your records.

Who needs employee attestation of covid-19?

01
Employees working in essential services and industries during the COVID-19 pandemic need an employee attestation of covid-19.
02
Employers may require all employees, regardless of their role, to fill out the attestation form to ensure a safe working environment.
03
Companies that need to comply with government guidelines and regulations related to COVID-19 may request their employees to fill out the attestation form.
04
New employees joining the company or returning employees after a leave of absence may also be required to fill out the employee attestation of covid-19.

What is Employee Attestation of Covid-19 Vaccination Form?

The Employee Attestation of Covid-19 Vaccination is a Word document needed to be submitted to the specific address in order to provide some information. It has to be completed and signed, which may be done manually, or via a particular solution such as PDFfiller. This tool allows to fill out any PDF or Word document directly from your browser (no software requred), customize it according to your purposes and put a legally-binding electronic signature. Right after completion, user can easily send the Employee Attestation of Covid-19 Vaccination to the relevant recipient, or multiple individuals via email or fax. The blank is printable too due to PDFfiller feature and options offered for printing out adjustment. Both in electronic and in hard copy, your form should have a clean and professional appearance. It's also possible to turn it into a template for further use, so you don't need to create a new document from scratch. All you need to do is to edit the ready template.

Instructions for the form Employee Attestation of Covid-19 Vaccination

When you are ready to start submitting the Employee Attestation of Covid-19 Vaccination word form, you need to make clear that all the required info is well prepared. This one is highly important, as far as errors may lead to unpleasant consequences. It is always unpleasant and time-consuming to re-submit forcedly the whole word template, not to mention penalties caused by blown due dates. Working with digits requires a lot of concentration. At first glance, there is nothing complicated about this. Yet still, it doesn't take much to make a typo. Experts suggest to keep all the data and get it separately in a different document. When you've got a writable sample so far, you can just export this info from the document. In any case, all efforts should be made to provide accurate and solid info. Doublecheck the information in your Employee Attestation of Covid-19 Vaccination form when completing all required fields. You can use the editing tool in order to correct all mistakes if there remains any.

Employee Attestation of Covid-19 Vaccination word template: frequently asked questions

1. Is this legal to complete forms digitally?

According to ESIGN Act 2000, Word forms filled out and authorized using an e-signature are considered to be legally binding, similarly to their physical analogs. In other words, you're free to rightfully fill out and submit Employee Attestation of Covid-19 Vaccination .doc form to the establishment required to use electronic solution that meets all requirements depending on its legitimate purposes, like PDFfiller.

2. Is it secure to submit personal documents from web application?

Yes, it is completely risk-free thanks to features delivered by the app that you use for your workflow. As an example, PDFfiller delivers the benefits like these:

  • Your data is kept in the cloud backup that is facilitated with multi-tier encryption, and prohibited from disclosure. It's user only who's got access to data.
  • Each writable document signed has its own unique ID, so it can’t be forged.
  • User can set extra security like user verification by photo or security password. There is an way to protect the entire directory with encryption. Put your Employee Attestation of Covid-19 Vaccination word form and set your password.

3. Is it possible to upload required data to the word template from another file?

To export data from one document to another, you need a specific feature. In PDFfiller, we name it Fill in Bulk. By using this one, you are able to export data from the Excel spread sheet and put it into your file.

Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.9
Satisfied
39 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

With pdfFiller's add-on, you may upload, type, or draw a signature in Gmail. You can eSign your employee attestation of covid-19 and other papers directly in your mailbox with pdfFiller. To preserve signed papers and your personal signatures, create an account.
Create, edit, and share employee attestation of covid-19 from your iOS smartphone with the pdfFiller mobile app. Installing it from the Apple Store takes only a few seconds. You may take advantage of a free trial and select a subscription that meets your needs.
Get and install the pdfFiller application for iOS. Next, open the app and log in or create an account to get access to all of the solution’s editing features. To open your employee attestation of covid-19, upload it from your device or cloud storage, or enter the document URL. After you complete all of the required fields within the document and eSign it (if that is needed), you can save it or share it with others.
Employee attestation of COVID-19 is a declaration made by employees regarding their health status related to COVID-19, confirming whether they have tested positive, are experiencing symptoms, or have been in contact with an infected person.
Employees who are returning to work or interacting in person within the workplace after being exposed to COVID-19 or after showing symptoms may be required to file an employee attestation.
To fill out the employee attestation, the employee typically needs to provide personal identification details, report any recent symptoms or COVID-19 related incidents, and certify the accuracy of the provided information with their signature.
The purpose of employee attestation is to ensure workplace safety by monitoring health conditions, preventing the spread of COVID-19, and complying with health regulations and workplace policies.
The information that must be reported includes the employee's health status, any symptoms experienced, potential exposure to COVID-19, recent travel history, and confirmation of understanding related safety protocols.
Fill out your employee attestation of covid-19 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.