COVID-19 Vaccine Status

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Use this form

to provide the dates of your COVID-19 vaccination series and booster doses

OR

to declare your exception because:

1. You are currently in the waiting period for when a booster can be provided. See the CDC site for current recommendations.

OR

2. You have an existing COVID-19 vaccine exemption in place. Note: You will need to submit a medical or religious accommodation form for review, if you currently do not meet Macalester's COVID-19 vaccination requirements.

Name *

Macalester ID *

Macalester Email *

Campus category *

Student

Staff

Faculty

Contract employee

Please identify your current status *

I have received a COVID-19 booster dose.

I am in the "waiting period" and cannot currently receive a booster dose.

I have an existing COVID-19 exemption in place.

Date of primary dose #1

YYYY

Date of primary dose #2 (if applicable)

YYYY

Date of booster dose

YYYY

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