Free Proof of Vaccination Affidavit Template

You may require a Proof of Vaccination Affidavit when organizations request formal confirmation of vaccination in Affidavit form.

This can include requests from, but is not limited to, the following organizations:

• Private employers
• Post-secondary educational institutions
• Professional programs, internships, or practicum placements
• Regulated professions and licensing bodies
• Healthcare-related workplaces
• Government contractors and federally regulated workplaces
• International employers and overseas institutions
• Airlines, transportation providers, or travel-adjacent organizations

Note: Acceptance of a Proof of Vaccination Affidavit is at the discretion of the requesting organization and commissioning the Affidavit does not guarantee acceptance.

A Proof of Vaccination Affidavit enables you to officially confirm your vaccination status. It creates a formal paper trail that organizations can use to satisfy internal policies, compliance requirements, or administrative processes.

More specifically, you might need this Affidavit for the following purposes:

• Confirm vaccination status when official records are unavailable or inaccessible
• Supplement existing vaccination documents
• Standardize internal verification for employees, contractors, and program participants
• Document compliance with workplace, institutional, and program-specific policies
• Support onboarding, access control, and eligibility assessments
• Maintain records for audit, compliance, and risk-management purposes
• Fill administrative gaps where public health documents can’t be verified
• Confirm vaccination for temporary, remote, and international arrangements

Your Proof of Vaccination Affidavit must include specific information for it to be considered valid. Ensure that you include the below information in your Affidavit:

• Full legal name
• Current address
• Date and location of birth
• Citizenship status
• A statement clearly confirming which vaccines you’ve received
• The date you received each vaccination

Some institutions may also request supporting documents to accompany your Affidavit. These documents can include the following:

• Proof of identity (government-issued ID)
• Copies of vaccination records or certificates
• Other supporting documentation requested by the recipient organization

Your Proof of Vaccination Affidavit must be commissioned by an authorized official, like a notary public or commissioner of oaths. This is a necessary step, and without it, your Affidavit isn’t valid.

You can meet with a notary online to have your Affidavit commissioned in 7 minutes, from anywhere with a Wi-Fi connection.

How Commissioning Your Affidavit Works

You can commission your Affidavit online through a secure video appointment. During your online notary appointment, the following will take place:

• You’ll present a piece of valid, government-issued ID to verify your identity.
• You’ll swear or affirm that the contents of your Affidavit are true.
• You’ll confirm that you understand the document and are signing voluntarily.
• You’ll sign and date the Affidavit while a notary witnesses in real time.
• A notary signs and applies their official stamp or seal.

To learn more about the commissioning process, check out our guide.

Note: Knowingly providing false information may be considered perjury under Canada’s Criminal Code.