NUNM Academic Events Tracking - National University of Natural Medicine

NUNM policy for on campus events states that all attendees must be either vaccinated against COVID-19 or have taken a COVID-19 PCR test 48-hours prior to the event with proof of negative results. All attendees must fill out the following form for tracking purposes. Thank you for your understanding.

NUNM Academic Event Tracking

This form is the responsibility of the NUNM Office of the Provost.

NUNM Member Status*
If you are a staff, student or faculty member at NUNM, please select from the following. If you are neither of these, please select guest.
Name*
First Last
Email*
Date of Birth*
MM slash DD slash YYYY
COVID Vaccination Status*
Are you currently vaccinated against COVID-19
- Yes
- No
Submit Proof of Vaccination*
Accepted file types: jpg, jpeg, png, gif.
Please upload a picture of your vaccination card.
Submit Proof of a Negative Covid-PCR Test*
Accepted file types: jpg, jpeg, png, gif.
Please upload a picture of your negative covid-test result that has been conducted within the last 48-hours. This test must be from a PCR test.
Acknowledgement*
I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may result in removal from this NUNM event and any future NUNM events.
I agree to this statement