Algoma Public Health Immunization education session completion form Back Animal Bites & Rabies Flu Hand Washing Infectious Diseases Infection Prevention and Control Hub Vaccines and Immunization School and Child Care Immunizations School-based Immunizations Updating School Immunizations View & Submit Immunizations Adult Immunizations Disease and Illness > Vaccines and Immunization > Immunization Exemption > Immunization education session completion form > Share On Immunization education session completion form Notify Algoma Public Health that you have completed the Immunization Education Session by filling out the form below. If you are seeking an exemption for more than one child, please complete a form for each child. Notify Algoma Public Health that you have completed the Immunization Education Session by filling out the form below. If you are seeking an exemption for more than one child, please complete a form for each child. Parent or guardian full name (first and last) Parent or guardian phone number (xxx) xxx-xxxx Parent or guardian email address Child's full name (first and last) Children's date of birth (YYYY/MM/DD) Child's Ontario Health Card Number (xxxx-xxx-xxx) Child's street address City Province Postal code Name of child's school As the parent or guardian of the child listed above; I confirm that I have watched the entire Vaccine Education video. I understand that watching the video is a requirement of the Ontario Ministry of Health. If your child is 16 years of age or older: my child has given me permission to submit this form on their behalf.
