COVID-19 Vaccination Attestation Form

Report your vaccination status, as defined by the Policy on COVID-19 Vaccination for the Core Public Administration Including the Royal Canadian Mounted Police .

Privacy statement

Review and Acknowledge Privacy Statement

The Treasury Board (TB), as the employer for the Core Public Administration, has a duty to ensure the health and safety of employees in the workplace. Vaccination against COVID-19 will be a requirement for all federal public servants as part of the approach to protect federal public servants and the community from COVID-19 and ensuring safe workplaces. Vaccination will add a layer of protection that will work with other public health measures to combat the spread of the virus.

The purpose for collection and use of this information is to fulfill the responsibility of your employer to ensure the health and safety of employees. This is a requirement under section 124, Part II of the Canada Labour Code and under the Policy on COVID-19 Vaccination for the Core Public Administration Including the Royal Canadian Mounted Police . Personal information is collected pursuant to section 7 and 11.1 of the Financial Administration Act and in accordance with the Privacy Act. The personal information collected will be used to confirm your vaccination status and to consider requests for accommodation for those unable to be vaccinated. The personal information will be used, in conjunction with additional COVID-19 preventative measures, including rapid testing, to determine if you will be granted on-site access to the workplace and to determine whether you may report to work in person or remotely. Your personal information will also be used by your organization and TBS to monitor and report on the overall impact of COVID-19 and compliance with the vaccination program both within the organization and for the Core Public Administration, as described in standard personal information bank PSE 907, Occupational Health and Safety.

Personal information may also be used to facilitate personnel administration in the employing organization and to ensure continuity and accuracy when an employee is transferred to another organization as described in standard personal information bank PSE 901, Employee Personnel Record. The centralized collection, use, and disclosure of your personal information is described in TBS central personal information bank (under development).

Refusal to provide the requested information may result in employees being refused on-site access to the workplace, whether you may report to work in person or remotely and other administrative consequences such as employees being placed on leave without pay, until they are fully compliant. Under the Privacy Act, you have the right to access your personal information and request corrections to your information. Should you wish to exercise your rights under the Privacy Act, or have any questions about this statement, please contact your organization's ATIP Coordinator. You have the right to file a complaint with the Office of the Privacy Commissioner about the handling of your personal information.