COVID-19 First Dose Vaccination Registration Form

In partnership with The Hospital for Sick Children (SickKids), we are offering everyone ages 12-17 years old COVID-19 vaccination.

The Hospital for Sick Children (SickKids), affiliated with the University of Toronto, is Canada’s most research-intensive hospital and the largest centre dedicated to improving children’s health in the country.

Adult Consent: I am authorized to consent for the patient named below to receive this vaccine. I request that the vaccine be given to the patient named below.

Please note this form is to be used for FIRST DOSE vaccination only.