Form Builder

Required fields are marked with asterisks (*)

Submit an Exemption Form - Immunization of School Pupils Act

Version française

COLLECTION OF PERSONAL HEALTH INFORMATION

We collect, use, and disclose your personal and personal health information under the authority of the Health Protection and Promotion Act R.S.O. 1990, c.H.7, s.5, the Immunization of School Pupils Act (ISPA), R.S.O. 1990, s.11(1) and its Regulations. This information is collected for the purpose of reporting on the immunization status of children going to schools or enrolled in a licensed childcare program in the province of Ontario. Information collected is maintained in an immunization system provided by the Ontario Ministry of Health. Questions about this collection of information should be sent to the Immunization Unit Supervisor at Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, 613-580-6744.

Under the Immunization of School Pupils Act (R.S.O. 1990), children aged four to 17 years who attend elementary or secondary school in the Ottawa area, must have up-to-date immunizations according to Ontario's Publicly Funded Schedule, or provide a valid exemption.

I acknowledge that I have read, understood, and accept how information will be collected, used, and disclosed by Ottawa Public Health.
 


Contact Us