Forms & Resources

• Immunization Questionnaire for Day Nurseries
• Immunization Records - What Every Parent Needs to Know - For Child Care
• Monthly Child Care – Immunization Report
• Statement of Conscience or Religious Belief for Child (for children under 4 years of age)
• Statement of Conscience or Religious Belief for Child (for school aged children / over 4 years of age)

 The following steps must be taken to ensure your child is exempt from the vaccination for medical reasons:

1. Complete the Statement of Medical Exemption for Child form. Speak with your physician to have this form completed. This form must be signed by a physician or a nurse practitioner.
2. Return the ORIGINAL copy of the signed exemption form to the Timiskaming Health Unit. 

• Pre-Employment Immunization Form for Childcare Staff 

For questions, please contact childcarehealth@timiskaminghu.com.

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