Covid-19 Vaccination Verification / Testing Consent

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All AUSD students need to be vaccinated against Covid-19, or tested weekly. The deadlines to provide documentation or testing consent are January 3, 2022 for students 12 years and older, and January 26, 2022 for students from 5 to 11 years old. In the absence of vaccination documentation or testing consent, students will be enrolled automatically in Independent Study. This form describes ways to submit documentation of your student's vaccination, or to begin the consent process for weekly Covid-19 testing.

Email *

Student's School *

Albany Middle

Albany High

MacGregor High

Cornell Elementary

Marin Elementary

Ocean View Elementary

Student's First Name *

Student's Last Name *

Student's Date of Birth *

YYYY

Student Covid-19 Vaccination Status *

Covid-19 Vaccinated. AUSD must receive proof of vaccination. Photos of vaccination card can be sent to mlau-seim@ausdk12.org (AHS), or cfloresca@ausdk12.org (AMS), or the student can show a photo of, or actual vaccine card, to Asst. Principal Lau-Seim (AHS) or Asst. Principal Floresca (AMS) at school.

Not Vaccinated. Student will need to be PCR tested weekly at school for Covid-19 or enter Independent Study (online learning).

For unvaccinated students only! Indicate your preference:

Weekly COVID-19 testing at school (instructions for providing consent for testing will be provided by email).

Enroll student in long-term Independent Study. (Note that students can exit Independent Study after District receives vaccination verification or consent for Covid-19 testing.)

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