Form Builder

Required fields are marked with asterisks (*)

COVID-19 Immunization Discrepancy/Receipt Request Form

Complete this form if you have encountered a discrepancy in your COVID-19 immunization record in the Ontario provincial database, or if you require a copy of your vaccine receipt.

You should only submit this form if you meet the following criteria:

  • You are a resident of the City of Ottawa or
  • If the purpose of your submission is to report a dose discrepancy, that the dose in question was administered in the City of Ottawa.

Persons 16 years of age or older must submit requests themselves.

If the COVID-19 dose was administered outside of Ottawa, you would need to contact the Public Health Unit for that area.

If you do not have a COVID-19 immunization record with us, or the information you provided cannot be matched to the provincial database, you will receive an e-mail of what you can do next.

Do you meet the above criteria?
 


Contact Us