Book a Catch-Up Vaccine Clinic Appointment

This form is intended for students scheduling a routine/catch-up vaccine appointment, and guardians scheduling a routine/catch-up vaccine appointment on behalf of a student or child.

To schedule a COVID-19 vaccine appointment, visit durham.ca/COVIDVaccines to learn where to get vaccinated.

Carefully review the following:

1. The Health Department offers immunizations for individuals who are having difficulty accessing vaccines. From the options below, please select the one that applies to the student/child.

The student does not have an Ontario Health Card (OHIP) or the student’s/child's OHIP is currently expired.

The student/child does not have a family doctor/primary health care provider.

The student/child is unable to receive vaccines through a walk-in clinic, urgent care centre, or family doctor’s office.

2. Public health continually monitors vaccine safety, and serious reactions are rare. Has the student/child ever had a serious reaction to any vaccine?

No

Yes, and a formal public health investigation has been completed and public health has recommended further vaccines.

Yes, and a formal public health investigation has NOT been completed.

3. How did you hear about the Health Department vaccine clinics? (Select all that apply)

Friends or family

School board or school staff

Region of Durham or Health Department website

Health care provider (nurse, doctor, nurse practitioner, medical secretary)

Social media

Radio

Mall signage

Other