Booster Vaccination

Booster Vaccination

Statement of truth
Have you had your booster Covid-19 vaccine?

If so, you can claim 1.5 hours wage to cover the time of your appointment. As staff aren't being provided with a vaccination-card, we just ask that you complete this 'statement of truth' confirming that you have had your booster vaccination.
Please tick to confirm the following: *

I confirm that I have received my Covid-19 booster vaccination I understand that if I am found to be untruthful in this declaration, I may be subject to disciplinary action
Name *

First Name Last Name
Date of booster vaccination *

Day Month Year
Date
Signature *

Clear
Date *

Day Month Year
Date
You need to confirm both points to continue
Should be Empty: