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Mandatory Employee Clearance to Work
On-Campus Response Form

Please follow the directions as provided below.  Please do not return to work on-campus without written approval and contact Human Resources should you have any questions at


State law and Federal privacy rules and regulations require that immunization information be kept confidential and stored securely. Your immunization data is stored in a secure database that can only be accessed by authorized users. These users must sign an agreement and follow strict confidentiality and security policies.