COVID Vaccination Verification
Name
*
First Name
Last Name
Email
*
example@example.com
Please designate for which PWR! event/department you are uploading you COVID vaccination
*
PWR! Retreat Attendee
PWR! Retreat Companion
PWR! Retreat Volunteer
Other
How will you be sending your COVID vaccination documentation?
*
I have or will be faxing it to 1-888-780-0154 as soon as possible.
I want to upload it in this HIPAA compliant form.
Please upload your verification documentation here. File formats allowed in this form are: pdf, doc, docx, jpg, jpeg, png, gif
*
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