Report your COVID-19 Vaccination Status

For Students

The information requested on this form is collected for the purpose of notifying WRH Employee Health of your COVID-19 vaccination status and will be kept private and confidential.

Questions or issues submitting this form? Please email VaccinePolicy@wrh.on.ca


Download a digital copy of your COVID-19 vaccination receipt here.

 

Demographic Information

 
 
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COVID-19 Vaccine Status

This information will be reviewed by Employee Health and kept private and confidential.

 
Please choose ONLY ONE option below to indicate details from your COVID Vaccine status

  
Delete Current File
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Delete Current File
 
 

Consent

 

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