Elementary School Vaccine Consents

Personal information is collected under the authority of the Health Protection and Promotion Act, Section 5, and in accordance with the Personal Health Information Protection Act and/or the (Municipal) Freedom of Information and Protection of Privacy Act, for the purposes of providing public health programs and for statistical purposes. Grey Bruce Public Health may utilize your name and email address to contact you at a future date to gather feedback on this program, which you may choose to provide. Questions about the collection and use of personal health information should be directed to the office of the Privacy Officer, Grey Bruce Public Health Unit, 101 17th Street East, Owen Sound ON N4K 0A5, 519-376-9420, 1-800-263-3456 or privacyofficer@publichealthgreybruce.on.ca.

*NOTE: Men-C-ACYW135 is required for school attendance

This vaccine is not routinely available through your primary health  care provider. They are required to order this from Grey Bruce Public Health. Once administered, this must be reported to GBPH via:
On-Line: https://gbhu.icon.ehealthontario.ca/
Fax: 519-376-7782
Email: immunization@publichealthgreybruce.on.ca
Telephone:  519-376-9420 or 1-800-263-3456 Press "2"

Please report this immunization to Grey Bruce Public Health via:
On-Line: https://gbhu.icon.ehealthontario.ca/
Fax: 519-376-7782
Email: immunization@publichealthgreybruce.on.ca
Telephone:  519-376-9420 or 1-800-263-3456 Press "2"

This vaccine is not routinely available through your primary health  care provider. They are required to order this from Grey Bruce Public Health. Once administered, this must be reported to GBPH via:
On-Line: https://gbhu.icon.ehealthontario.ca/
Fax: 519-376-7782
Email: immunization@publichealthgreybruce.on.ca
Telephone:  519-376-9420 or 1-800-263-3456 Press "2"

The Health Care Consent Act states that all persons, regardless of age, may consent to medical treatment, provided they understand the benefits and risks of the treatment as well as the benefits and risks of not having the treatment. There is no minimum age in Ontario for informed consent. Students will be assessed by a nurse at the school clinic, based on the principles of the Health Care Consent Act, to ensure that informed consent can be obtained. Students who present to the clinic without a signed consent are offered the opportunity to delay immunization(s) or consult with a parent or guardian as they see fit. Parents/Legal guardians are encouraged to talk with their children about the benefits/risks of immunization prior to the clinic. You can find more about the Health Care Consent Act at https://www.e-laws.gov.on.ca/

When you submit this form, Grey Bruce Public Health will receive your answers. All questions should be directed to the Vaccine Preventable Diseases Team at Grey Bruce Public Health by calling 519-376-9420 or emailing vpd@publichealthgreybruce.on.ca