Rhode Island Hospital Volunteer Flu Vaccination Status

Brown University Health volunteers are required to follow the seasonal influenza vaccination policy. Once you have submitted your annual update to employee and occupational health services, please complete this form.

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Date of My Most Recent EOHS Filing per the Influenza Vaccination Policy

Annual Influenza Vaccination Policy Adherence

Compliance with the Brown University Health Seasonal Influenza Policy is required for all Brown University Health volunteers.

Contact your manager with any questions about this policy.

I agree that providing my name electronically to this agreement is the legal equivalent of my manual signature and that all information contained here is accurate.

I certify that I have filed with Brown University Health employee occupational health services (EOHS) per the annual influenza vaccination policy requirements.

Yes