NOCCCD Vaccination Program

Vaccination Information

The North Orange County Community College District is requesting information about your vaccination status for the following legitimate and non-discriminatory business purposes:

  1. To maintain a safe and healthy workplace as required under Labor Code section 6400, et seq.
  2. To permit compliance with federal, state, and local laws and regulations related to COVID-19, including the Emergency Temporary Standards (Cal/OSHA COVID-19 Regulations) (See 8 C.C.R. ?? 3205-3205.4)
  3. To ensure the continued safe operation of North Orange County Community College District services.

Please do NOT provide information related to any health or medical conditions or any other confidential medical information while completing this form. For more information, please visit https://www.nocccd.edu/district-updates.


The Health Insurance Portability and Accountability Act (HIPAA) provides safeguards to protect your privacy. Additional information is available from the U.S. Department of Health and Human Services at www.hhs.gov.

"Fully vaccinated" means at least fourteen (14) days have passed since I received either (1) the second dose of a two-dose COVID-19 vaccine series (Moderna, Pfizer/BioNTech) or (2) a single-dose COVID-19 vaccine (Janssen (Johnson & Johnson)). Vaccines must be Food and Drug Administration (FDA) approved and have emergency use authorization.

Dosage Information

The vaccination upload process allows students and employees to upload their vaccination records for verification. Once the record has been verified, you will receive an email and the verification result will be available in myGateway.

Prepare your vaccination record - Create a digital copy/picture of your COVID-19 Vaccination document. A smartphone photo will work. Make a note of the following information:

  • Lot Number
  • Dose Date
  • Administered State

Where to find your information on the Vaccination Record Card 

Vaccination Card Sample

Please note: It is not sufficient to just upload your vaccination record. Failure to enter COVID-19 vaccination dates will result in non-compliance with medical clearance requirements. COVID-19 vaccinations administered outside of the United States will be subject to review..

* Required field

Vaccination record upload

Choose a copy of your COVID-19 vaccination record and click Upload. Files must be less than 5MB and in the .PDF, .PNG, or .JPG format to be accepted. Up to two files can be uploaded..


Acknowledgment

HIPAA and PHI Information and Consent Form
Vaccine Verification Services

The Health Insurance Portability and Accountability Act (HIPAA) provides safeguards to protect your privacy. Implementation of HIPAA requirements officially began on April 14, 2003. Many of the policies have been our practice for years.

Specifically, there are rules and restrictions regarding who may see or be notified of your Protected Health Information (PHI). These restrictions do not include the normal interchange of information necessary to provide you with office services. HIPAA provides certain rights and protections to you as the patient. Those needs are balanced with the goal of providing you with quality professional service and care. Additional information is available from the U.S. Department of Health and Human Services. www.hhs.gov

The following policies exist to protect your information:

  1. Patient information is kept confidential except as necessary to provide services or to ensure all administrative matters related to your care are handled appropriately.
  2. You agree to bring any concerns or complaints regarding privacy to the immediate attention of Student Services.
  3. Your confidential information will not be used for the purposes of marketing or advertising of products, goods, or services.
  4. Access to results is provided at your request and in accordance with state and federal laws.
  5. You have the right to request restrictions in the use of your protected health information and to request changes in certain policies used by North Orange County Community College District concerning your PHI.

VACCINE VERIFICATION DATA CONSENT
Per North Orange County Community College District's health and safety policy, and as a condition of employment, you hereby consent to allow verification of your vaccination status in the state or other jurisdiction’s immunization registry in which you received vaccinations.  By your enrollment at North Orange County Community College District you are agreeing to allow Healthcare IT Leaders via TrackMy Solutions to verify any vaccination data that you report to us or give us by way of an uploaded image of a CDC vaccination card, or by inputting data into a third-party system. TrackMy Solutions will attempt to verify vaccine data on your behalf, by querying the state or other jurisdiction’s registry where you indicate the vaccine was administered and return this result to you in a secure format. You are authorizing TrackMy Solutions, and a third-party pharmacy or other healthcare providers that is a partner of TrackMy Solutions, to provide you with healthcare services that include verifying your vaccination status and determining any recommended dose of the COVID-19 vaccine or other vaccine recommended by the Advisory Committee on Immunization Practices, you will become a patient of the pharmacy through use of the pharmacy services listed prior.  You understand that the results of this query of a state registry could return your full vaccination record. Healthcare IT Leaders, TrackMy Solutions and its partner organizations will handle all information obtained in a confidential manner and limit access to the minimum number of individuals necessary. You agree to share your vaccination status with your employer and your employer will only be provided with the minimum information necessary to demonstrate that you have satisfied any vaccination mandate that has been deemed to be a condition of employment. At no time, will Healthcare IT Leaders or TrackMy Solutions disclose your confidential information to any additional entities without your authorization. Falsifying records is a criminal offense, thus please enter information that is fully accurate and to the best of your knowledge.  If initial verification cannot be completed, you authorize Healthcare IT Leaders and TrackMy Solutions to use a third-party intermediary to reach out to you, to gather additional information to verify your vaccination status. If North Orange County Community College District is providing you with doses of vaccinations, you agree to authorize Healthcare IT Leaders and TrackMy Solutions to report required information about those doses to the appropriate state registry to satisfy immunization reporting requirements.

Employees: To request a medical and/or religious exemption from the required COVID-19 vaccination, please complete the form here.

Exemption upload

Choose a copy of your exemption and click Upload. Files must be less than 5MB and in the .PDF, .PNG, or .JPG format to be accepted..


Your vaccination record has been received and is awaiting verification. Check back here for more updates.

Self-attested: I have been fully vaccinated against COVID-19. "Fully vaccinated" means at least fourteen (14) days have passed since I received either (1) the second dose of a two-dose COVID-19 vaccine series (Moderna, Pfizer/BioNTech) or (2) a single-dose COVID-19 vaccine (Janssen (Johnson & Johnson)). Vaccines must be Food and Drug Administration (FDA) approved and have emergency use authorization.

For more NOCCCD updates, please visit https://www.nocccd.edu/district-updates.

Thank you. Your vaccination record has been uploaded and verified.

Verification Date: {{MyInfoDetails.VERIFIED_DATE}}

Self-attested: I have been fully vaccinated against COVID-19. "Fully vaccinated" means at least fourteen (14) days have passed since I received either (1) the second dose of a two-dose COVID-19 vaccine series (Moderna, Pfizer/BioNTech) or (2) a single-dose COVID-19 vaccine (Janssen (Johnson & Johnson)). Vaccines must be Food and Drug Administration (FDA) approved and have emergency use authorization.

For more NOCCCD updates, please visit https://www.nocccd.edu/district-updates.

Employees: Your exemption request will be reviewed. Please check back for more updates.

The medical and/or religious exemption forms for the required COVID-19 vaccination can be found here.

For more information, please visit https://www.nocccd.edu/district-updates.
Students: Your exemption request will be reviewed. Please check back for more updates.

For more information, please visit https://www.nocccd.edu/district-updates.

Your records have been rejected. Please upload your vaccination record again.

For more information, please visit https://www.nocccd.edu/district-updates.

If you have any questions, please email covidmandate@nocccd.edu. If you are using the Safari browser, please update it to the latest version.

The NOCCCD Vaccination Program page is not available at the moment. Please check back later.

For more information, please visit https://www.nocccd.edu/district-updates.

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Your vaccination record has been received and is awaiting verification. An email will be sent to you once the results have been returned.

For more NOCCCD updates, please visit https://www.nocccd.edu/district-updates.