All Utah Connections Academy students must provide evidence of their immunizations.
Please submit one of the following:
- A Utah School Immunization Record (Pink Card) signed by a licensed physician,
registered nurse, or public health official.
- If the Utah School Immunization Record is not signed by a license physician,
registered nurse, or public health official, it must be accompanied by a current
copy of the student’s shot record signed by a licensed physician, registered
nurse, or public health official.
- Any immunization record signed by a licensed physician, registered nurse or
public health official.
A student may be exempt from immunizations for medical, religious, or personal belief
reasons. To receive a vaccination exemption form, the legally responsible individual
of a student must complete an online education
module (free of charge), print the vaccine exemption form, and present the
form to the school.
If the legally responsible individual declines to complete the online education
module, he/she must receive an in-person consultation at the local health department
($25.00 fee may apply), sign the exemption form at the local health department, and
provide a copy of the completed school immunization exemption form to the school
For a medical exemption from vaccination, the legally responsible individual of the student must present to the school a completed vaccination exemption form and a written notice signed by a licensed healthcare provider stating that due to the physical condition of the student, administration of the vaccine would endanger the student’s life or health.