Scarcity Exemption Form For USC Students currently in non-U.S. locations, Planning Enrollment at USC I , ________________________________________, have read the policy pertaining to my obligation as a USC student to complete the COVID-19 vaccination requirements in order to access the USC campuses, as stated in the link below: https://policy.usc.edu/covid-19-vaccination-program I attest that I am currently unable to complete COVID-19 vaccination with the vaccines currently accepted by the University of Southern California, listed at the link below: https://studenthealth.usc.edu/list-of-accepted-vaccines due to the following circumstances: Scarcity of these vaccines in my current country of residence (unable to get vaccinated). Previous vaccination with a non-WHO EUL-listed vaccine, __________________________________(vaccine name) that prevents me from receiving another vaccination in my current country of residence__________________________. Other circumstances:
I INTEND TO STUDY IN THE U.S. — I agree to start a COVID-19 vaccination series that meets university policy within 3 business days of arrival to the United States. I agree to comply with COVID-19 safety measures and requirements (including Trojan Learn training, COVID-19 testing, and wellness screenings, as applicable) as directed by university officials in order to access USC campus facilities. Initial: _______ I CONFIRM MY COURSE OF STUDY IS OUTSIDE OF THE U.S. — I cannot receive an approved vaccine at this time. If I enter the U.S., I agree to start a COVID-19 vaccination series that meets university policy within 3 business days of arrival to the United States. I agree to comply with COVID-19 safety measures and requirements (including Trojan Learn training, COVID-19 testing, and wellness screenings, as applicable) as directed by university officials in order to access USC campus facilities. Initial: _______ NAME:
USC ID:
Semester / Year I intend to enter the U.S. for study: SPRING / SIGNATURE:
FALL /
SUMMER of (indicate year) DATE:
mm / dd / yyyy
Instructions: Upload this document to the student health portal: https://usc.edu/myshr. Contact covid19@usc.edu with any questions. 111021_SCAREXPT
V: 11/11/21