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Non-Medical Exemption for Students Attending School in Ottawa

Collection of Personal Health Information

We collect, use, and release 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, and 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 assessing, keeping records, and reporting on the immunization status and exemptions of children going to schools in the province of Ontario. Information collected is maintained electronically in a provincial immunization information system that is provided by the Ontario Ministry of Health. Information will be collected, used, and disclosed in accordance with the Personal Health Information Protection Act, 2004, S.O. 2004, c. 3. Questions about this collection of information should be addressed to the Supervisor, School Immunization, Ottawa Public Health by mail at 100 Constellation Drive, Ottawa, ON K2G 6J8 or by e-mail at

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

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