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Immunization Information Form Vancouver Coastal Health Childhood Immunization History

Immunization Information Form Vancouver Coastal Health Childhood Immunization History

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Spirit Community 2110 West 43rd Avenue 604. IMMUNIZATION INFORMATION Dear Parent/ Guardian VCH must have a record of each child s immunization history. Yes No Don t know. Attach a photocopy of your child s immunization record OR fill out the following record. If one of the diseases listed below occurs in your school/childcare facility and immunizations are not complete the Medical Health Officer may require your child to stay at home. Please complete and return this form to the school/childcare...
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