COVID-19 Vaccination Status and Safety Controls Confirmation

This vaccination status and safety controls confirmation allows you to voluntarily confirm your COVID-19 vaccination status and agree to follow the controls based on your vaccination status and location. This may allow certain COVID-19 protocols to be optional for you.

All responses will be kept in accordance with applicable law and 3M policies. In order to administer the program, 3M may share your vaccination status with your supervisor, other site management, Occupational Medicine, and HR on a need-to-know basis only. 3M reserves the right to end or modify this program at any time.

This form is intended only for 3M workers residing in selected jurisdictions in the United States.  Do not complete this form if you are residing in the US State of Montana. Do not complete this form if you are residing outside of the United States.