Flu Vaccine Mandate for Staff Members

Our top priority at Connecticut Children’s is to keep each other and our patient families safe. That’s why the organization is once again requiring all team members – in clinical and non-clinical roles – to receive a flu vaccine for the 2023-24 flu season as a condition of employment. If you have any questions about the details below, please send them to questions [at] connecticutchildrens.org.

Who The Flu Vaccine Requirement Applies To

The flu vaccine requirement applies to all staff of Connecticut Children’s, including team members, licensed independent practitioners, students, volunteers, contracted and traveling staff in all locations (including those who work remotely).

How To Submit Your Vaccine Proof

IMPORTANT! No matter where you receive your flu vaccine you will need to submit proof using the online form below… even if you received your flu vaccine at an onsite clinic!

Submit your proof of receiving the flu vaccine using this 2023/24 Vaccine Proof Form.

If you prefer, you can access the 2023/24 Vaccine Proof Form using the QR code below from any mobile device.

staff vaccine qr code

Note: If you are accessing this link inside Connecticut Children’s network, please click on “Your Company/Corporate Account” when logging in to use the form. If you need help, please call the Help Desk at 860.545.8090.

Your Flu Vaccine Proof Needs To Include Certain Information

To be accepted, your proof must include certain types of information. If any details are missing, you will be asked to resubmit the proof, and it won’t be considered compliant until all of the required information has been received. When asking for proof of vaccine please request your vaccine administration record.

Your FLU VACCINE proof needs to include all of these details:

  • Name
  • Date of birth
  • Vaccine name/lot number
  • Date of vaccine  

Here are two examples of the types of FLU VACCINE proof that are accepted:

walgreens flu vaccine proof example
flu shot sample 2

Important: Prescription stickers and/or store receipts, like the one below, are NOT accepted as valid proof:

Prescription incorrect proof for flu vaccine

Please ask for a copy of the completed consent that has the flu vaccine label with the vaccine information on it or the Vaccine Administration Record.

In addition, if you receive your flu vaccine at your local doctor’s office please inform them that you need proof of receiving the vaccine as a condition of employment.

Flu Vaccine Exemption Requests

Please download the appropriate exemption form below, complete it and ensure all the required signatures are provided.

Flu Medical Exemption Form (pdf)  
Flu Religious Exemption Form (pdf)  

To submit your exemption request, print out your completed form, take a photo of it with your cell phone and then click here or use the QR code below.

QR Code - flu shot submission of exemption

If you were exempt from our flu vaccine requirement previously, no action is needed. Please continue to follow the same guidelines.

Resources To Support You

Instructions for Submitting An Exemption Request

Instructions for Submitting Vaccine Proof

Confirm Your Proof Was Received

You can confirm your flu vaccine proof was properly received and recorded using this report. Note that after submitting your proof, our Infection Prevention team will need to validate it. So, it could take 24 hours (or longer on weekends) for the proof to appear in the report.

Need A Copy of Your Proof?

Once your proof has been validated, you can download a copy of the document you submitted here.