Voluntary Reporting of COVID-19 Vaccine Outside of the Yale Program

Individuals with COVID-19 vaccination performed outside of the Yale COVID-19 Vaccine Program may voluntarily submit their COVID-19 vaccination record to the university. By doing so, it will ensure that your vaccination status is on record with the university for COVID-19 monitoring across the Yale community. In addition, your record will be added to your Yale Health / Yale New Haven Health electronic health record and available to you within your MyChart account. Please note that if you received your vaccination through Yale New Haven Health, it is considered outside of the Yale Program.

Complete this form once you have recived your full vaccination (i.e., received both doses of a two-dose series)

As you complete the form, you will need to upload a copy of your official government COVID-19 vaccination card provided by the vaccination site. The file can be a photo or scanned image. Before accessing the form, it will be helpful to have this file saved to your computer or phone.

To upload the image of your vaccination card on your phone, select “Browse” when prompted within the form and take a photo of your card.,

To upload the image of your vaccination card from your computer, scan it and save to your files or take a picture of it, email it to yourself and save it to your files.  To upload it within the form, click “Browse,” select “Browse” to find the find the image in your files.

Access the forms via the portals below: