Feature

McLaren Health Care is required by CMS and OSHA to report its employee vaccine status and COVID-19 training for all employees. This information is required to be submitted to CMS by October 1, 2021. In order to be compliant with these federal mandates, it is essential for all employees to complete the survey, attest and certify for vaccination and training status.

* denotes required field

First Name *

Last Name *

Employee Number *

• McLaren Employees: Use your employee number
• Providers: Use the last 4 digits of your phone number followed by a "P"
• Contractor / Vendor (without a McLaren HealthCare employee ID): Use "Contractor"
• Students [all students without McLaren employee ID]: Use “Student”

What is your organization? *

McLaren Bay Region
McLaren Bay Special Care
McLaren Caro Region
McLaren Central Michigan
McLaren Flint
McLaren Greater Lansing
McLaren Lapeer Region
McLaren Macomb
McLaren Northern Michigan
McLaren Oakland
McLaren Port Huron
McLaren St. Luke ́s
McLaren Thumb Region
McLaren Health Management Group
McLaren Corporate Building
Corporate Auburn Hills
CBS - Shelby
MMG Corporate Building
MMG
Contractor or Vendor
MDwise
McLaren Health Plan
Karmanos

Vaccination Questions

Have you received the COVID-19 vaccination? *

yes
no

Vaccine Status Attestation

I attest to the authenticity, accuracy and veracity of the information that I have provided regarding my vaccination status. I understand and agree that this information may be further verified and authenticated. I acknowledge that if there is a discrepancy, inaccuracy or false information, my vaccine status will be deemed unvaccinated for the purpose of personal protective equipment and safety requirements. *

If you receive a COVID-19 vaccine after this survey, please bring a copy of your COVID-19 vaccine card to employee health services

OSHA - Emergency Temporary Standard [ETS]

Please click on this link for the comprehensive training document to meet the OSHA-ETS 1910.502 (n) standard that requires the employer must ensure that each employee received training related to COVID-19.

OSHA-ETS Information also available for review on McLaren Intranet

I attest and certify that I have received and reviewed McLaren Health Care’s COVID-19 OSHA -ETS (Emergency Temporary Standard) Training document. *