Get Canada Middlesex-london Health Unit Hepatitis B And Meningococcal A/c/y/w135 Vaccine Consent Form 2013-2025

Filling out the Canada Middlesex-London Health Unit Hepatitis B and Meningococcal A/C/Y/W135 Vaccine Consent Form online is an important step in ensuring vaccination for students. This guide provides clear, step-by-step instructions to assist users in completing the form with confidence.

Follow the steps to successfully complete the vaccine consent form online.

1. Press the ‘Get Form’ button to access the vaccine consent form. This will allow you to view and complete it in an online format.
2. Begin by filling out the student's last name, first name, date of birth (year, month, day), and age. Make sure all provided information is accurate and complete.
3. Enter the health card number, the name of the school, and the phone number for emergency contact. This information is essential for the health unit to process the consent effectively.
4. Complete the parent/guardian's business number, street address, city, and postal code. Ensuring the correct details helps maintain contact and follow-up when necessary.
5. Respond to the health-related questions regarding allergic reactions to vaccines, the possibility of pregnancy, and any bleeding disorders. This information is crucial for the safety and effectiveness of the vaccines.
6. For the Hepatitis B vaccine section, indicate any known allergies to specified components such as thimerosal, yeast, and latex. Answer whether the student has ever had a hepatitis B infection or received the vaccine previously.
7. In the Meningococcal A/C/Y/W135 vaccine section, indicate any known allergies to diphtheria toxoid and whether the student has received a meningococcal C vaccine within the last month.
8. Sign the consent sections for both the Hepatitis B and Meningococcal A/C/Y/W135 vaccines. The signatures from both the student and the custodial parent/legal guardian are required, therefore ensure that both parties provide their names and dates of the signatures.
9. Review the entire form for accuracy and completeness. After ensuring all information is correct, you can save changes to the form, download it for personal records, print a copy, or share it as required.

Complete the Canada Middlesex-London Health Unit Hepatitis B and Meningococcal A/C/Y/W135 Vaccine Consent Form online today to ensure timely vaccination.