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City of Hamilton - Public Health Services

Immunization Forms

Report Your Child's Immunizations:

The Immunization of School Pupils Act requires that Public Health audit and record the immunization records of ALL City of Hamilton students, as well as children attending licensed daycare facilities. Your child should be immunized against 6 diseases: Measles, Mumps, Rubella, Diphtheria, Tetanus and Polio.  Proof of immunization is required to attend school in Ontario; this information can help protect your child in the event of certain outbreaks.

Please note that family doctors are NOT responsible for calling Public Health and reporting your child’s immunization information. This is the parent’s/guardian's responsibility.

To report your child's immunization record:
 
1. Complete the enclosed Immunization History Form, or submit a copy of your child's Yellow Immunization Card.

Immunization History Form - English (pdf)
Immunization History Form - French(pdf)

If your child can not be immunized for conscience, religious or medical reasons, please follow the instructions as listed in the following letters. 

Religious or Conscience Exemption Letter (pdf) (French pdf)
Religious or Conscience Exemption Form (pdf)

Medical Exemption Letter  (pdf)
Medical Exemption Form: available through a family doctor


2.  Submit your child's immunization information to Public Health, in one of the following ways:

Phone: 905-540-5250
Mail: P.O. Box 897, Hamilton, ON L8N 3P6
Fax: 905-546-4841
In Person: 1 Hughson Street North, 6th floor

School Based Immunization Programs

The following immunizations are offered free of charge to students through school-based immunization programs.


Hepatitis B and Meningococcal Vaccine Immunizations.
Available to all Grade 7 Students.

Hepatitis B Consent Form - English (pdf)
Hepatitis B Consent Form - French(pdf)

Meningococcal Vaccine Consent Form - English (pdf)

Human Papillomavirus (HPV) Immunization:
Available to Grade 8 Female Students ONLY.
HPV Immunization Consent Form (English) pdf
HPV Immunization Consent Form (French) pdf

For more information contact:

Phone 905-540-5250
Mail P.O. Box 897, Hamilton, ON L8N 3P6
Fax 905-546-4841
In Person 1 Hughson Street North, 3rd floor
Email publichealth@hamilton.ca
Email is for general inquiries only. For inquiries about your immunization record, please call using the phone number noted above.

Last updated: October 20, 2010