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Please fill out the below form to provide necessary information about your planned vaccination clinic(s) under Ottawa Public Health’s authorized organization. Please DO NOT share any sensitive, personal and/or client information in this form.
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If you have already been in contact with a City of Ottawa/Ottawa Public Health staff member, please include their name here. If not, please leave this section blank.
Please provide the name and address of the location where you plan to administer vaccines.
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