Voluntary Vaccination Status Reporting for Reynolds Students

Voluntary Vaccination Status Reporting
for Reynolds Students

Reynolds School District encourages all eligible students to be fully vaccinated against COVID-19 to help protect our community by reducing the potential for serious illness, hospitalization, or death. It also will limit disruptions to the school year and allow us to resume more in-person instruction and activities.

Please use the form below to voluntarily provide vaccine verification to limit your student's need to quarantine in the event of an exposure to COVID-19.

Parent/Guardian's Name:*

First NameLast Name

Student's Name:*

First NameLast Name

Student's ID #:

(if known)

Student's School:*

Student's Grade:*

Proof of Vaccination:*

Photo of vaccination card, screenshot from healthcare provider or pharmacy app, scan of official record from doctor's office, etc.

Digital verification:*

I hereby certify that the information I have provided herein is true and correct to the best of my knowledge.