LeadingAge Maine & New Hampshire

Vaccine Verification Portal

LeadingAge Maine & New Hampshire Annual Conference & Expo
Accushield is proud to be the official LeadingAge Maine & New Hampshire health and screening provider. All Personal Health Information (PHI) stored is HIPAA-compliant.
Attendee Full Name *

First Name Last Name
E-mail used to register *
example@example.com
Mobile Number
Please enter a valid phone number.
Please provide Mobile Phone Number: (hit "confirm" to verify mobile) *
All attendees are required to upload the following document: Proof of COVID-19 Vaccination
LeadingAge Maine & New Hampshire Annual Conference & Expo requires all attendees to be fully vaccinated against COVID-19. While we encourage anyone eligible for the booster to receive it, to be considered fully vaccinated, it must be at least 14 days after your second dose in a 2-dose series (Pfizer or Moderna) or a single-dose vaccine (Johnson & Johnson/Janssen).

Upload an image of your vaccination card below. Multiple files are accepted.
Cancel of
By signing and clicking the submit button below, you are acknowledging that an inherent risk of exposure to COVID-19 exists in any place where people are present. By attending the LeadingAge Maine & New Hampshire Annual Conference & Expo, you voluntarily assume all risks related to exposure to COVID-19 and agree not to hold LeadingAge Maine & New Hampshire or any LeadingAge affiliates, directors, officers, employees, agents, contractors, or volunteers liable for any illness or injury.

Clear
Data is encrypted at rest by default at an Enterprise Server:Enterprise solution is completely isolated from the JotForm environment, so nothing is shared with other users.All data (user's forms/submissions etc.) is automatically encrypted at rest while being written to the physical disks.Each encryption key is also encrypted with master keys managed by Google Cloud Platform (our hosting partner).Encryption at rest database, available on HIPAA, is one level above that:Our servers get the raw data, and while writing it to the database, we encrypt it with AES256 (every individual submission has a unique key) and every individual AES256 key is also encrypted with the user's public key (RSA2048). Keys are seamless to users and completely managed by JotForm. In short, the regular enterprise setup provides disk encryption, whereas HIPAA adds database encryption over it.
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Vaccine Verification Portal

All attendees are required to upload the following document: Proof of COVID-19 Vaccination