Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters.
Grade 7 School Based Immunization Clinics

What You Need to Know Before Continuing

As required by the Immunization of School Pupils Act (ISPA), students attending school in Ontario need to be immunized according to Ontario's Immunization Schedule

INSTRUCTIONS FOR CUSTODIAL PARENTS/LEGAL GUARDIANS: Complete this form only for students that will be in Grade 7 in September. In order to consent or refuse vaccination, this form must be completed prior to the vaccination date. For more information visit wechu.org/immunization or call 519-258-2146 ext. 1222.

This webpage can be translated by clicking on the ear icon.

Cette page Web peut être traduite en cliquant sur l'icône de l'oreille.

يمكن ترجمة صفحة الويب هذه من خلال النقر على أيقونة الأذن


Esta página web se puede traducir haciendo clic en el icono del oído.

Please complete this form by September 27, 2024, so that the Windsor-Essex County Health Unit is aware if you want or do not want your child to receive vaccinations in the 2024-2025 school year. It will take about 15 minutes of your time to fill out this form.

Please have the following information ready before filling out this form:

• The name of the school your child will attend

• Your child's vaccination records

This form will remain private and confidential and will only be used by the Windsor-Essex County Health Unit. If you have any questions, call the Healthy Schools Department at 519-258-2146 ext.1222.