COVID-19 Policy Acknowledgement, Health Attestation & Proof of Vaccination (required for facility entry)

FCTV remains committed to providing a safe and welcoming environment and has instituted guidelines for anyone entering Falmouth Community Television (FCTV) facilities. 

Health and safety protocols have been adopted from best practices of the film and television industry, currently in use by production studios here in Massachusetts and adapted as resources allow. 

UPDATED October 18, 2021 - anyone entering our facilities or using the FCTV production vehicle must be fully vaccinated against COVID-19, provide one-time proof of vaccination (see below), and fill out and sign this form.

This form must be submitted a minimum of two but no more than 24 hours prior to entry.


Please Read
Please indicate your level of COVID-19 vaccination.
(Fully vaccinated occurs two weeks after receiving the second dose of the two-dose vaccine (Moderna or Pfizer) or two weeks after the single-dose (J & J) vaccine or upon receiving the booster shot as recommended by the CDC when eligible.) *Term 'Fully' is subject to change based on CDC guidance.

Secure Share Link

To upload your proof of vaccination securely, please click here or plan to arrive at FCTV ten minutes early with proof of vaccination.


Please sign your name and initials and date the form below.