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Request a form

Health Care Providers, your requested form(s) will be emailed to you after you submit this form.

Which form(s) would you like sent to you?

Beyfortus Order Form

Biological Returns Form

Child Care Centres Pre-Employment Health Form

Contingency Plan for Planned or Unexpected Electricity Disruption

HCP RSV Vaccine Order Form

Hepatitis A High Risk Eligibility Vaccine Order Form

Hepatitis B High Risk Eligibility Vaccine Order Form

Holding Point Application

HPV High Risk Vaccine Order Form

Immunization Assessment Plan

Incident Assessment Form for Designated Officers

Influenza Immunization Decision Making Tool

LTC / RT Routine Vaccine Order Form

LTC / RT RSV Vaccine Order Form

Meningococcal High Risk Eligibility Order Form

Min/Max Thermometer Order Form

Report of Positive Tuberculosis (TB) Skin Test

Request for Immunization Schedule Assessment and Plan

Routine Vaccine Order Form

School Program Vaccine Order Form

Sexually Transmitted Infection Medication Order Form

TB Physician Referral Form

Vaccine Cold Chain Incident Exposure Report

Vaccine Storage and Handling Request Form

Varicella Immunity Confirmation Form

Please provide us with your email address

Region of Waterloo Form