Vaccine Compliance Participant detailsName* First Last Phone*Date of birth* DD slash MM slash YYYY Email* Employee type*CSIRO team memberScience participantCrewVaccination detailsCompliance status* Fully vaccinated Awaiting second dose Valid medical exemption Not vaccinated and does not hold a valid medical exemption Dose 1 date DD slash MM slash YYYY Dose 2 date DD slash MM slash YYYY File uploadMax. file size: 200 MB.Please upload your proof of vaccination or a valid medical exemption. Privacy statement and consentAspen Corporate Health (ACH) is committed to your privacy and will handle any information you provide to us in this survey in accordance with the Australian Privacy Principles (APPs) and the Privacy Act (Cth). ACH, on behalf of CSIRO’s Marine National Facility (MNF), is collecting this data in order to assess your medical clearance and to provide better support to you in the area of physical, mental health and wellbeing onboard the Marine National Facility. ACH will only disclose a survey response as required or authorised by law. A survey result may be discretely shared with the MNF should there be an issue with medical clearance.Consent I have read the privacy statement and give my consent to ACH to collect and store my medical records on behalf of CSIRO. I also understand that ACH will inform CSIRO of my vaccination compliance status.