Greetings Puget Sound Students!
In an effort to create the safest campus environment this fall with the goal of returning to a normal campus experience, the University of Puget Sound has adopted a mandatory immunization policy. This policy requires 2 MMR (measles, mumps and rubella) and the COVID-19 vaccine(s) for students. Consistent with the policy, you must provide proof of two MMR vaccines and COVID-19 vaccination (2 Pfizer, 2 Moderna, 1 Johnson & Johnson or WHO/CDC approved COVID-19 vaccines) by August 2, 2021. Documentation of your vaccines must be received before August 2 to be eligible for fall classes.
Given the new immunization policy we are also requiring all students to review and update their Health History form via the CHWS portal by August 2, 2021. You will upload your COVID vaccine dates and upload an image of your vaccine card in the CHWS portal through the Medical Clearances section. Double check to be certain your MMR vaccine dates are accurate.
If you have chosen not to receive vaccinations for religious or medical reasons, you must follow the steps below.
- Sign the immunization waiver and acknowledgment below and submit to CHWS. This can be uploaded to the CHWS portal under downloadable forms, dropped off in person, or sent by mail.
- You must also provide one of the following exemption request forms depending on your type of exemption:
- Medical exemption forms must be completed by your primary care provider.
- Religious exemption must include a statement of religious belief which will be reviewed by CHWS staff and the university chaplain.
- You must meet with a CHWS representative to review the current health and safety standards required by the university. You will be notified of how to make this appointment if you are given approval for the waiver.
If you waive the COVID-19 vaccine you will be required to test for COVID-19 regularly and follow all university requirements for unvaccinated students. You acknowledge that in the event of a measles, mumps, rubella and/or COVID-19 outbreak on campus, you will be excluded from classes or other campus activities, or be asked to leave campus, until proof of immunity is demonstrated or until the outbreak has ended.
In the event of an outbreak, no exceptions to standard University policy for tuition adjustments or refunds will be available. Please submit this form to CHWS by uploading it into the CHWS portal.
Kelly K. Brown, Ph.D. | Director
Counseling, Health, and Wellness Services
IMMUNIZATION WAIVER AND ACKNOWLEDGMENT
By signing below, I affirm that I have chosen not to receive one or more vaccinations for religious reasons or that I am unable to receive one or more vaccinations for medical reasons for measles, mumps, or rubella and/or COVID-19, and that I am requesting to be exempt from the university’s immunization requirements. I understand that this request must be approved by the Director of CHWS or the Director’s designee and is contingent on my providing appropriate documentation to support the request. If my request is approved, I understand that I may still be subject to university testing requirements or other health and safety standards and I will be required to meet with a representative from CHWS to review the current health and safety standards required by the university. I further understand that in the event of a measles, mumps, rubella, and/or COVID-19 outbreak on campus, I may be excluded from class or other campus activities, or asked to leave campus, until I have proof of immunity or the outbreak is over. No exceptions to standard University policy for tuition adjustments or refunds would be available in those circumstances.
Please check the following box/boxes according to your exemption request and provide appropriate documentation to CHWS through the CHWS portal to support this request.
☐ MMR vaccine requirement (complete Certificate of Exemption, located on CHWS website)
☐ COVID-19 vaccine requirement (complete Certificate of Exemption, located on CHWS website)
Student Name (Printed) Date of Birth
Student Signature Date
Parent Signature (if student is under 18) Date