Recording Immunization and Report Forms

Besides recording immunizations that are given on the client’s record or chart, clients should be provided with a record of their immunization.
  • Report Immunizations administered to children up to and including 18 years of age to the local Health Unit in a timely manner so that data can be entered into the electronic public health record. A copy of the reporting form will be provided with the vaccine. 

Vaccine Reporting Forms:

South Island Form [PDF]: Greater Victoria, Sooke, Saanich, Gulf Islands

Central Island Form [PDF]: Duncan, Cowichan Valley, Ladysmith, Nanaimo, Qualicum, Port Alberni, west of Port Alberni

North Island Form [PDF]: Courtenay, Campbell River, Gold River, north of Campbell River