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Vaccine Education Certificate request

  • This questionnaire is part of the process to obtain an immunization exemption for your school-aged child(ren) for conscience or religious beliefs.
  • Your child(ren) must attend a school in Huron or Perth counties.
  • This questionnaire is to be completed after watching the Ontario Ministry of Health's Vaccine Education Video.
  • All fields are required.

If you require assistance, please call Huron Perth Public Health at 1-888-221-2133 ext. 3558.

By checking this box, I acknowledge that I have watched the Vaccine Education Video.

Parent/legal guardian information

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