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COVID-19 Vaccination - No Health Card

Contact information

Complete this form if you do not have a health card and are:
  • Looking to book an appointment for a Health Canada approved vaccine; or
  • Need to access your COVID-19 vaccine receipts                    
Important considerations

Walk-ins are welcome at all Public Health vaccine clinics. No health cards or appointments are necessary.           

Please bring some form of government-issued identification.
  • If you would like to bring your passport, work / travel VISA, birth certificate, permanent residency card, or refugee claim documents, this is up to you. We don't ask for proof of your immigration status to get a vaccination.
  • No personal information collected during a vaccination activity can legally be shared with the employer, immigration or enforcement.
  • Mass immunization clinics also accept expired identification and can even proceed with no identification, if necessary
By completing and submitting this form you understand and accept the following:
  • You are providing your personal information to be contacted for a COVID-19 vaccination
  • Your personal information and personal health information may be accessed, used, and disclosed by authorized individuals at Niagara Region Public Health and/or Niagara Health Services for the purpose of determining your eligibility and coordinating your vaccination
  • You are asked to provide your email address and telephone number. We recommend you use a secure email address for optimal security of communications. If you choose to use non-secure personal email, you accept any privacy and security risks related to use of non-encrypted email.
  • The information you provide is accurate and true
  • Information collected will be securely stored by Niagara Region Public Health for a one-year period and protected in accordance with MFIPPA / PHIPA. If you have questions about privacy at Niagara Region, contact us at 905-980-6000 ext. 3779
  • Your participation in this process is voluntary
1. Contact information
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