AUTHENTICATING VACCINATION STATUS FOR INDIVIDUALS SUBJECT TO THE ORDER
Individuals subject to the Executive Order may prove their COVID-19 vaccination status by providing Northeast Medical Institute a copy of any one of the following categories of documentation:
1) A CDC Vaccination Card AND a declaration signed by the individual attesting to the authenticity of the card. It is a crime under federal law to use, buy, sell, or transfer a CDC vaccination card knowing that the card is fraudulent. A violation of this federal law is punishable by a fine or imprisonment of up to five years. 18 U.S.C. SEC. 1017; or
2) A record from the individual's vaccine provider indicating the type of vaccine and the date(s) administered ("Provider Vaccination Record"). Individuals may contact their vaccination provider to request a copy or log into the patient portal for that provider; or
3) A certificate from the Vaccine Administration Management System ("VAMS"), if the individual received vaccination through the V AMS system ("V AMS Certificate"). Individuals may log into V AMS;
The Executive Order requires all individuals and facilities to obtain the appropriate immunization documentation by the September 7th deadline. Processing delays with vaccine providers, VAMS, or DPH will not excuse compliance with the Executive Order.
***All Contracted staff MUST be vaccinated. Exemptions are not allowed***
CDC COVID-19 Vaccination Card Declaration
Declaration Attesting to the Authenticity of an Individual's CDC COVID-19 Vaccination Card
Pursuant to Executive Order No. 13B, a long-term care facility shall ensure individuals with direct access to a patient or resident of a long-term care facility are fully vaccinated against COVID-19, partially vaccinated by September 7, 2021, or exempted from the vaccine requirement for medical or religious reasons. Individuals submitting a CDC vaccination card to verify their vaccine status must also include a declaration attesting that the card is authentic.
I declare that the attached is a copy of the CDC vaccination card I received when I was vaccinated for COVID-19 and that the information on the card is true. I understand that it is a crime under federal law to use, buy, sell, or transfer a CDC vaccination card knowing that it's fraudulent. A violation of this federal law is punishable by a fine or imprisonment of up to five years. 18 US. C. SEC 1017;