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Licensed Child Care Entry Immunization Form

Updated: June 2019

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Gastrointestinal Outbreak Line Listing Form - Child Care

Reviewed: June 2022

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Non-Reusable Vaccine (Spoiled or Expired) Return Form

Updated: 2021

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IMT-218 - Publicly Funded Hepatitis A & Hepatitis B Order/Report Form

Updated: March 2019

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Hep B Vaccine Order And Referral Form

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Statement of Medical Exemption COVID-19 Immunization- Public Use

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Flu Vaccine Wastage Form - Pharmacy

Updated September 2023.

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Flu Vaccine Wastage Form - Health Care Providers

Updated September 2023.

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2023-2024 Seasonal Influenza Consent Form

Updated October 2023.

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Vaccine Temperature Log Book

Updated September 2023.

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Special Events - Organizer Application Form

For a fully accessible version of this form, please fill out the HTML-based form found here: Special Events - Organizer Application Form

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Special Events - Food Vendor Application Form

For an accessible version of this form, please fill out and submit the HTML-based Food Vendor Application Form

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Food Donor List

This list is required to determine if any potentially hazardous food has been donated to the event

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Consentement à l’administration du vaccin Menactra

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Grade 7 Immunization Consent Form

Current as of September 2024.

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