Coronavirus/COVID-19 Information

State Employee Vaccination Certification Process

Per CSU policy, vaccinations against COVID-19 are required to access campus facilities and participate in in-person learning and activities this fall. Faculty and staff should have at least one vaccine shot before August 16. You must be fully vaccinated (two weeks after your final dose) and submit your certification information by September 30.

Using the appropriate form, employees will indicate whether: 

  • you have been vaccinated and upload a picture of your vaccine record 
  • you qualify for a medical or religious exemption 
  • you do not plan to access any campus facilities or participate in any in-person activities  

You should certify your information as soon as you are fully vaccinated (or know they plan to pursue an exemption) so we can begin verification.

View frequently asked questions and answers about the vaccine policy.

How do I submit?

  • State employees should add their information in PeopleSoft using the instructions that follow. 
  • Associated Students employees should submit their vaccine certification in UKG as directed by AS Human Resources. 
  • Chico State Enterprises employees will receive additional information in their email.
  • Student employees submit their certifications through their Student Center accounts.

COVID-19 Vaccine Self-Certification State Employee Instructions

**For the best experience, we recommend using a desktop or laptop computer to complete this form.

1. Log In to the Self Certification Page

Log in to the Employee COVID-19 Self-Certification page using your Chico State username, password, and DUO authentication. 

Some employees have experienced trouble logging into the self-certification portal. We recommend clearing your browser cache and then trying the link or trying a different browser. 

Screenshot showing vaccine form in PeopleSoft

2. Complete Section I: Self-Certification of COVID-19 Vaccination Status

You may only check one box in this section. If you need to change your selection after submitting, just return to the page and select the updated option. Links on the page provide additional information.

Receipt of Approved Vaccine

When you select the first option, Receipt of an Approved Vaccine, a new section will appear to add information about the vaccine and dates received. Areas marked with a red asterisk (*) are required. If the vaccine requires two doses (e.g., Moderna), both dates must be completed. Location information is optional.

Screenshot showing the options when "receipt of an approved vaccine" is checked with options to enter vaccine dose information

Medical and Religious Exemptions

In addition to completing the COVID-19 Vaccine Self-Certification, employees must also complete the appropriate forms to be eligible for an exemption. Requesting an exemption does not guarantee approval. Additional paperwork must be submitted so that each request for exemption can be evaluated and approved. Information submitted in support of exemption requests will be maintained confidential and only shared on a need-to-know basis.

Questions regarding medical exemptions should be addressed directly to ARC at

Questions regarding religious exemptions should be addressed to

3. Complete Section II: Self-Attestation of Accuracy of Information Provided.

This is required. You will not be able to submit without having confirmed this section.

4. Section III – Attachments (if applicable)

Upload Vaccination Record

If you selected “Receipt of Approved Vaccine,” you can attach a picture of your COVID-19 Vaccination Record.

First, create a digital copy or picture of your COVID-19 vaccination card—a smartphone photo will work! Upload documentation in one of the following formats:

  • Bitmap Image (.BMP)
  • Graphical Interchange Format (.GIF)
  • JPEG Image (.JPG/.JPEG)
  • Portable Graphics Format (.PNG)
  • Portable Document Format (.PDF)

Note: iPhone/iPad users may need to convert their photo file prior to uploading. Many iPhones default to .HEIC photo file types, so you will need to convert to a standard format to upload. A simple way to do this is to open the photo of your vaccine card in the Photos app and take a screenshot. The screenshotted image will be a .JPG file.

Successful upload example:

Screen shot showing a successful upload with the filename displayed

5. Submit

You only need to hit "Submit" once, and don't need to resubmit if you have made no changes. Once submitting, you will receive a message that reads, “Thank you for submitting your COVID-19 Vaccine information.”

6. Finish

Click “Finish” to complete the process.

Screenshot showing the message once the form is submitted, which says thank you


General questions about the vaccine self-certification process should be directed to in new window).

Contact the Office of Accessible Technology and Services at 530-898-6532 or if you need assistance accessing and completing the form.