Fraser health immunization form. Immunizations are recorded at the Health Unit.

Fraser health immunization form Fax or mail; Send a copy of the child’s immunization record by fax or Feb 26, 2024 · Health Gateway provides B. This form will allow community vaccine providers to submit non-urgent immunization consultation requests any time of day, including weekends, with a response time of two to ten days from Public Health. Other employees can update their immunizations at specific site based immunization clinics run throughout Fraser Health sites throughout the year. How do I report immunization records? There are three ways to report your immunization record. In order to give informed consent, you will need to read about the vaccines your child will be receiving before you arrive at your appointment with Public Health. fraserhealth. The B. Please advise parent to retain a personal record. Please complete and include. Reach out to the HCAP team at hcap@fraserhealth. The Licensee is to maintain a record of each person in care’s participation in the annual influenza immunization program. Health unit fax numbers and addresses are available by clicking on the health unit name. (Refer to Appendix 2 - Immunization Form for Employees. Tdap-IPV We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. ca/immunizationform To make an appointment for immunization at a public health unit: • Call 604 -702 4906 if you live in Mission, Abbotsford, Chilliwack, Agassiz, or Hope. ca Website: https://www. ca; Both influenza and COVID-19 vaccine orders will be submitted using the online vaccine order request form. Public health units will have vaccines available for children under 12 years of age. If you are unsure if your immunizations are up to date, please review with your family doctor or call your local public health unit. Getting immunized protects your health and prevents the spread of disease between you and your patients, and between you and your family and friends. Immunizations for babies at two months; Immunizations for children at 12 months %PDF-1. Discuss your travel plans with your health care provider at least 6 to 8 weeks before you travel because most vaccines take several weeks to become fully effective and others may need more than one dose. We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. That’s why Fraser Health focuses on ensuring that every 2-year old in our region is up-to-date on their immunizations. Fax: with vaccines being returned to Public Health. Resident immunization status for the above recommended immunizations is: Complete (person in care has all recommended immunizations) Medical certificate/record is on file Yes No t available Incomplete If incomplete or unknown immunization status: (check all that apply) Person in Care encouraged to obtain recommended immunizations. Reports adverse reactions following immunization to the Occupational Health Nurse. You must be successful in the education component to maintain your position as a health care support worker and participation in the Health Career Access Program. ca/immunize If you have questions, please call your local public health unit. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Community Vaccine Provider - Vaccine Return Form . Once a request is approved, Fraser Health will book their immunization appointment and transportation arrangement together. ca if you need assistance connecting with the college for support. Residents in any other area of Fraser Health, call 604-476-7087. Fraser Health hosts cohort check-in's throughout your time at college. your local public health nurse. You may need it later to sign up for daycare or school, to travel or to take to the hospital in case of emergency. My Health Record Resources Fraser Health Resources Home Health Service line 1-855-412-2121 Virtual Health Care 1-800-314-0999 Provincial resources To speak to a nurse, Pharmacist or dietician dial 8-1-1 For community resources dial 2-1-1 Crisis line 1-800-suicide (1-800-784-2433) Anti-fraud centre 1-888-495-8501 Immunization communication tool for immunizers COVID-19 Immunization Communication Tool 5. PHC Location: Date: and volunteer’s immunization status, even if the immunizations are incomplete. Fraser Health has a legal duty under FOIPPA to assist all requestors and respond openly and in a timely manner. People 73 years of age (born 1948) and older can now book through Fraser Health’s 24/7 online booking tool for their COVID-19 vaccine appointment or by calling the call centre. - Online: Submit a photo of your immunizations record to public health on our the health care record on behalf of another health care provider (HCP). , available every day. You are also required to self-report if you decline vaccination. Informed Consent for Immunization Video Scenarios BCCDC Immunization Manual Appendix A - Informed Consent for Immunization Form/Documentation Quantity COVID-19 Immunization Entry form 1 per resident Mar 28, 2025 · The vaccine is available at approximately 400 pharmacies, as well as health authority clinics, some primary care offices, community health centres, long-term care homes and First Nations communities. ) The FOR IMMUNIZATION (WRITTEN) . Complete and sign the consent form. 5°C) KNOW the Accuracy Range of Your Thermometer 1. You can add or update a record to the B. Who can use this service. Please complete, sign and return the consent form to your child’s school. 0°C (+/ (+/-) _____°C For Identifying & Reporting CCIs Refrigerator Name : Month: Year: A new online Fraser Health immunization consultation form for community vaccine providers has been created. The intent of this informed consent standard of practice is to achieve a more client-centered, consistent, and expeditious approach. Fraser Health: Immunization Records Apr 30, 2020 · If you are an employee of a BC health organization and you are encountering problems with submitting your vaccination and immunization history using the online self-reporting tool, please contact the Provincial Workplace Health Contact Centre at 1-866-922-9464 (select Option 1) or email HH@WHCallCentre. A record is defined as any form of recorded information, whether physical, digital, written, or video. Scan the QR codes below and read the information about the recommended vaccines. Request your or your child’s immunization records by completing the Request for Information form. ca Contact. The vaccine management support nurse (VMSN) team is part of the FHA Public Health Immunization Logistics program, offering eligible FHA community vaccine providers (CVPs) onsite one-on-one individualized support with a focus on vaccine management, temperature monitoring and providing supporting clinical resources to ensure your office is set up for vaccine management success! You will be asked to give informed consent for immunization. Fraser Health Regional Immunization Logistics Team - 02 December 2024 Example of Correctly Filled Out Refrigerator Temperature Form - Including Cold Chain Incident Examples KNOW the Refrigerator Name (if multiple): Accuracy Range of Your Thermometer (+/-) 1. 0 °C Factor in for spotting & reporting CCIs Fridge #1 Month: November Year: 2025 You can make an appointment for immunization at a public health unit. This information is required, as it will allow public health and medical staff to quickly identify each person’s immunization status in the event of an outbreak. If you have urgent questions, contact your local Public Health Unit directly. 7 %âãÏÓ 262 0 obj > endobj 289 0 obj >/Encrypt 263 0 R/Filter/FlateDecode/ID[29E7C48F79534242AFE3C2DA18687FAE>]/Index[262 62]/Info 261 0 R/Length 124/Prev Influenza vaccine is the only immunization recommended annually. m. HLTH 2385 2018/05/16 (Revised by Fraser Health Communicable Disease Nurse Coordinator Team July 2018) We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. ca We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Parents can register their child in the Get Vaccinated provincial system to be notified of when your child can get vaccinated. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Fraser Enrollment/Discharge Fraser Evaluation Reports Fraser Family Information/Update Fraser Medication History Communication (verbal/written) Other: (specify) _____ _____ Any/all records Assessment Data Coordination of Services Discharge Summary Evaluation and/or Progress Reports Family Information Immunization Records Dear Health Care Provider: On October 19, 2021 the Ministry of Health announced a universal influenza vaccination program. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Sincerely, Dr. Health Information Management (HIM) represents Fraser Health, Providence Health Care, Provincial Health Services Authority, and Vancouver Coastal Health. ’s health authorities, including Provincial Health Services Authority (PHSA) and Providence Health Care (PHC), are under the immune status requirement. Regional Immunization CDNC Team – 07 February 2023 . Mpox is a disease caused by the mpox virus. These fields are marked with We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. It is the Licensee’s responsibility to assess the appointed Manager and ensure the following: The Manager is appropriately qualified, by education and experience. • Call 604 -476 7087 if you live anywhere else in Fraser Health. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living It is the professional and legal responsibility of the provider to obtain informed consent prior to immunization. If you require access or assistance with your Fraser Health email account, please visit our Email access webpage for more information; For Fraser Health personnel inquiries, please contact People Information & Benefits at 604-520-4420 or 1-877-795-4119 (toll-free); or by email at PIB@fraserhealth. Learn where to get immunized and how to book an appointment. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Fraser Health and the FHA Immunization Logistics Program is committed to achieving the highest standards in immunization practice. As a result, in support of B. Talk about the importance of vaccines with your parent or caregiver. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living An Integrated Online Order Form is available to request all publicly funded vaccines for routine immunizations (except for flu and COVID-19) from Fraser Health. Respond effectively to disease outbreaks in child-care facilities and schools. If you lose your child’s health passport, contact your doctor or Public Health for their immunization records and record it on: You do not need to report immunizations that are provided at a Fraser Health public health unit because those immunizations are recorded into Fraser Health’s system. Talk with the child about why vaccines are important. How to request your immunization records. We would like to show you a description here but the site won’t allow us. By immunizing infants we are also protecting individuals who cannot be immunized due to medical reasons as well as protecting the rest of our community from the spread of A website providing centralized health information resources to patients, physicians and clinicians, researchers, and institutions across Lower Mainland, Vancouver Island and the Okanagan. You may need these records for certain jobs, travel or school registration. Refer to the Pre-Employment Immunization Form below. You can make an appointment for immunization at a public health unit. ca/immunizationform. Recommended vaccinations for child care staff, students, and volunteers: Pre-employment Immunization Form for Childcare Staff (PDF, 2 pages) NOTE: This information may be reviewed by Fraser Health Authority Licensing staff as per legislation. Public email: reportimmunizations@fraserhealth. Immunizations are provided at public health units, doctors' or nurse practitioners' offices, and pharmacies throughout the province. ? and volunteer’s immunization status, even if the immunizations are incomplete. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Population & Public Health CD Team September 2016 Consent for Immunization Authorization I: _____ (Name of parent/guardian) We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Online: Submit a photo of your immunizations record to public health on our website at www. Review the attached form that lists the vaccines you need. In person: Drop off a photocopy of your immunization record to your public health unit. ’s new vaccination status reporting regulation, our public health staff will be checking the immunization records for kindergarten-age children. It is recommended and encouraged that parents/guardians discuss consent for immunization with their children. resident. Immunizations help provide the best start to life. Provincial Immunization Registry (PIR) if you are a B. All residents in British Columbia are encouraged to get vaccinated to protect themselves and their communities. For Health Unit Use Only . The COVID-19 vaccination is free for everyone in B. Note: Some fields are mandatory depending on the information you enter into the form. . ) The We would like to show you a description here but the site won’t allow us. Eligible people can book their […] In person; Drop off a photocopy of the child’s immunization record to the public health unit. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living health, safety, dignity, and rights of persons in care and maintain compliance with the legislation. Health Gateway provides access to: Blood test and other lab test results Eligible Fraser Health residents can request a ride by registering for their immunization on the provincial Get Vaccinated system and using the provided registration number to complete a transportation request form. %PDF-1. Immunizations are recorded at the Health Unit. report these immunizations to Public Health online by either scanning this QR code or going to fraserhealth. Please call: • 604-702-4906 if you live in Mission, Abbotsford, Chilliwack, Agassiz, Jan 2, 2025 · Keeping you and your family's immunization records up to date is important. Primary care providers: Order your routine vaccines online from Fraser Health - Fraser Health Authority Information and consent forms for grade 6 and grade 9 will be sent home at the beginning of the school year. ca Immunizations for travel can be given at a travel clinic, doctor's office or pharmacy. Facilities must comply with the Fraser Health Influenza Control Program Policy and the Influenza Outbreak Program Policy. This form is for non-urgent immunization questions only. This includes union and non-union employees, such as: Medical staff The spirit of FOIPPA is to promote transparency and trust of Fraser Health by the public. Patient Information Date of Immunization DD MM YY Client #1 Name Immunization information (last, first name): Td_ Vaccine Dose # Lot # Site Vaccine Dose # Lot # Site IPV (Polio) PHN# (care card): _ Tdap . If Health Gateway is missing immunization records, you can submit them: - In person: Drop off a photocopy of your immunization record to your public health unit. Anyone six months of age and older is eligible for the vaccine. In cases where a child’s immunization records are missing or incomplete, public health may contact the child’s family to provide missing immunization information. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Sep 23, 2024 · Influenza and COVID-19 Immunizations Report Form - Fill in all * Required fields CVPs with Provincial E-Form Access MUST Document Directly into the E-Form System * Clinic/Office details Include FULL site details _____ HEALTH UNIT STAMP Immunization Logistics Team – 23 September 2024 . Client #1 - Information Immunization information Our health authority partners may also provide additional information and assistance on requesting immunization records for vaccines provided by Public Health Units in their regions. Call; Report immunizations over the phone to the public health unit. You can view your vaccination records in Health Gateway. C. Carolyn Wonneck, MD, MSPH, CCFP, FRCPC Medical Health Officer – Medical Director Immunization Program, Fraser Health Authority To view this in other languages, scan the QR code We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Health Officers (MHOs) for public health programs and enables them to respond appropriately when a communicable disease outbreak occurs in a child care facility. Our goal is to provide a comprehensive immunization program that meets the standards and guidelines of the Canadian Immunization Guide and the British Columbia Communicable Disease Control Immunization Manual. ca even if you do not have your records. ca/health Check that the child’s immunization record is complete. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living To book an appointment (immunizations or dental flouride): Residents of Fraser East (Mission, Abbotsford, Chilliwack, Agassiz and Hope), call 604-702-4906. HPV vaccine is free for students in grades 6-12 and children 9-18 years of age in B. Mar 28, 2021 · Call the Fraser Health COVID-19 Immunization Booking phone line: 1-855-755-2455 As new age stratifications open, there may be high booking volumes on those days and in particular when the phone lines open at noon. Bring this booklet to each visit, record your child’s immunizations and keep it in a safe place. Fraser Health community immunization clinics; Participating pharmacies; Primary care providers; Walk-in clinic; Anyone who registered with the provincial Get Vaccinated system for their COVID-19 vaccine, will be sent an invitation and booking link for their flu vaccine via text or email. FACILITY USE ONLY Staff person reviewing family’s documents: SIGNATURE: PRINT NAME: DATE: CHILD’S WITHDRAWAL DATE: REASON FOR WITHDRAWAL: FRASER HEALTH IMMUNIZATION CLINIC SCHEDULE (For Flu Schedule see Page 2) PLEASE TAKE YOUR WORK ID AND EMPLOYEE NUMBER TO THE CLINIC October Date 11Oct 13Oct 16Oct 18OctSite Langley Memorial Hospital Central We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Mar 28, 2021 · FRASER Health on Sunday said it is working quickly to book COVID-19 immunization appointments and has accelerated the booking schedule. Immunization Schedule can help you determine when you or your family needs to be immunized and on the reverse side of this form will not be shared with your employer. Pregnancy Status: the health care record on behalf of another health care provider (HCP). Call to book an appointment. Please complete and return this form when registering your child for a child care facility. What routine immunizations are recommended in B. Telephone booking is available Monday-Friday, 8:30am-4:30pm. health, safety, dignity, and rights of persons in care and maintain compliance with the legislation. Anyone 12 years and older can use it. Complete the COVID-19 Immunization Entry Form for each immunization and submit it by fax to the appropriate Public Health office: Fraser North 604-528-5460 (fax) Fraser South 604-528-5461 (fax) Fraser East 604-528-5462 (fax) Fraser Health is offering HPV immunization at all schools in our region to students in grade 6-12 during the 2024/25 school year. Please return the completed form by fax, or drop it off at your local public health unit. to 10:00 p. Name of Employee / Provider / Volunteer: Name of Child Care Facility: Immunizations Status of Employee / Provider / Volunteer: Immunizations up to date Immunizations not up to date Appropriate documentation on file If you are not currently set up with Public Health as a vaccine provider and would like to be, contact your local Public Health Unit for additional information or the Immunization Logistics team: Immunizationlogistics@fraserhealth. Please call: • 604-702-4906 if you live in Mission, Abbotsford, Chilliwack, Agassiz, or Hope • Fraser Health information and resources on immunizations: FraserHealth. (We offer only the vaccines you need, as shown on the consent form). If you're unsure if your child’s immunizations are up to date, please review with your family doctor or call your local public health unit. A memo will be sent out at the end of September. Mar 1, 2013 · Health care workers are at risk of exposure to infectious diseases while at work. Parents and guardians can also add a dependent in Health Gateway to see immunizations for their children 11 years and younger. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Updated 10-2-2023 1 COVID-19 Long Term Care and Assisted Living Facilities COVID and Influenza Immunization Campaign Guide This guide will assist you in planning your COVID and Influenza clinics. Complete Sections 1, 2, and 3 (please print) Last Name: First Name: Date of Birth (YYYY/MM/DD): Address: Telephone Number: Emergency Contact and Relation: Emergency Telephone Number: Personal Health Number: Sex: Female Male Transgender . aged six months and older. CLIENT INFORMATION. You may be contacted to request your participation in the evaluation of this school immunization program. Mar 28, 2025 · Keeping your immunizations up to date helps protect yourself, your community and B. patients with secure and convenient online access to their health records. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Fraser Health Virtual Care Have questions or concerns about your health? Speak with a registered nurse from 10:00 a. Complete the COVID-19 Immunization Entry Form for each immunization and submit it by fax to the appropriate Public Health office: Fraser North 604-528-5460 (fax) Fraser South 604-528-5461 (fax) Fraser East 604-528-5462 (fax) We recognize that Fraser Health provides care on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region. Many diseases can be prevented with immunization. Both influenza and COVID‐19 vaccine orders will be submitted using the online vaccine order request form located on the Fraser Health Immunization resources for community vaccine providers webpage. If it is not complete, you can submit the missing record one of these ways: Include it with the signed consent form, or Submit it online to us at FraserHealth. - By fax or mail: Send a copy of your immunization record by fax or mail to your public health unit. Surrey, BC V3T 0H1 Go to fraserhealth. Fraser Health Authority - Regional Immunization Logistics Team – 02 December 2024 Refrigerator Temperature Form/Log - Document to one decimal place in °C (Example 4. Vaccination is especially important for people who are at higher risk of serious illness from COVID-19 (such as pregnant women, people 65 years and older and people with certain medical conditions) as well as people who provide essential community services. 4 %âãÏÓ 133 0 obj > endobj xref 133 61 0000000016 00000 n 0000001982 00000 n 0000002119 00000 n 0000002336 00000 n 0000002380 00000 n 0000004329 00000 n 0000004480 00000 n 0000004714 00000 n 0000005050 00000 n 0000005435 00000 n 0000005549 00000 n 0000005661 00000 n 0000005688 00000 n 0000006164 00000 n 0000006523 00000 n 0000006847 New employees are directed to call the Provincial Workplace Health Call Centre at 1-866-922-9464 to review their records and are referred to a clinic if required. Patient Education Professional Practice Fraser Health #400, 13450 102nd Ave. If directed to voice mail, leave the best number to be reached during the day and the call will be returned. Population & Public Health CD Team September 2016 Consent for Immunization Authorization I: _____ (Name of parent/guardian) Contact. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Jan 3, 2025 · Clinical and non-clinical health care staff employed or contacted by B. 604-702-4906 for residents of Mission, Abbotsford, Chilliwack, Agassiz and Hope; 604-476-7087 for all other areas of Fraser Health Employee immunization status for the above recommended immunizations is: Complete (employee has all recommended immunizations) Medical certificate/record is on file Yes No t available Incomplete If incomplete or unknown immunization status: (check all that apply) Employee encouraged to obtain recommended immunizations. Fraser Health is dedicated to serving all Indigenous people, and honours the unique cultures of the First Nations, Métis and Inuit living Vancouver Coastal Health needs to have an up-to-date record of your child’s immunizations so we can: Recommend immunizations your child may be missing. ’s health care system. Please call: • 604-702-4906 if you live in Mission, Abbotsford, Chilliwack, Agassiz, or Hope When can I self-report? Please self-report as soon as possible after receiving your influenza vaccination. Scan the QR code to access the web chat or call: 1-800-314-0999 Public Health Units Abbotsford 604-864-3400 104 - 34194 Marshall Road Agassiz 604-793-7160 7243 Pioneer Avenue Burnaby 604-918-7605 Child care centres are required to maintain staff vaccination records and provide them to Public Health upon request. *Exception - All staff applying to work in Fraser Health Residential Services will undergo a Tuberculosis and Immunization screen prior to commencing work as per the CCALA* Participates in Fraser Health’s screening, education and vaccination protocols. Provide the best care for your child through our public health programs. fqst ulax jgpe sfe sohec yzh bvvi pcbcvln fnjjv kaylm xwzy bycj wvgsu dsthv yakdmpxa