This form certifies that you or the minor child you are signing for are considered fully vacciated by CDC definition:
- 2 weeks after your second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
- 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine
You must complete this form if you wish to be in MakeHaven while community transmission is at substantial or high levels according to CDC county levels.
PLEASE NOTE: Staff reserves the right to have you produce a record of your vaccination. We suggest taking a photo of the card to have available in your phone, or putting a photocopy in your wallet.