Register a Record of COVID-19 Vaccination Received Outside of Ontario

To register a record of COVID-19 vaccination, please complete this form. Fields marked with an asterisk within the form are mandatory. Please ensure to include a valid phone number where you can be reached if we have questions about your submission. If you need assistance with this form, please call 1-866-318-0522.

Please note that it may take several days for your information to be registered into the provincial COVaxON Vaccination Management System. The Eastern Ontario Health Unit will contact you to let you know once your information has been entered and successfully processed. The health unit will let you know when you can book your second dose, if you require it, using the Provincial Booking System.

NOTE: Personal or personal health information submitted using this form will be collected under the authority of the Health Protection and Promotion Act, R.S.O. 1990 (or appropriate Act) and applicable privacy legislation. This information will be used for the delivery of public health programs and services and may be used for evaluation or statistical purposes. Any questions about the collection of this information should be directed to the Manager, Vaccine Preventable Diseases, Eastern Ontario Health Unit, 1000 Pitt Street, Cornwall, ON K6J 5T1 or call 613-933-1375 or 1-800-267-7120.