● Eligible children must be registered for Junior Kindergarten or already enrolled in school.

● Before beginning the education session, please review each step carefully.

● If you are unable to complete the vaccine education session online, please contact our office at immunization@rcdhu.com or 613-732-9436 to arrange completion of the session in person.

Step 1: Watch the Vaccine Education Video

If you don’t see the video above, CLICK HERE to watch the Ontario Ministry of Health Vaccine Education Video. The video is 28 minutes long, includes subtitles, and only needs to be viewed once per family.

Topics include:
• Immunization basics
• Vaccine safety
• Community health
• Ontario immunization laws

Step 2: Vaccine Education Session Quiz and Form

After watching the full video, complete the six-question quiz, followed by the Vaccine Education form. You will then be issued a Vaccine Education Certificate by mail or e-mail. Keep a copy for your records.

Step 3: Complete the Affidavit

Download the Statement of Conscience or Religious Belief form. The person completing this form must have a Vaccine Education Certificate.

Bring the completed form to a Commissioner of Oaths (listed below). Appointments may be required.
• Clerk, Deputy Clerk or Treasurer of your local municipality
• Member of Provincial Parliament
• Notary Public or Lawyer
• Justice of the Peace
• Any individual who is empowered by the Lieutenant Governor to be a commissioner (a stamp is required for these individuals)

The affidavit is a legal document, and RCDHU will not accept any changes to it.

Privacy Note: RCDHU collects the information in the affidavit and certificate to process non-medical exemptions under the Immunization of School Pupils Act and its regulations. For details about how RCDHU protects and uses information, see our Personal Health Information & Privacy Statement.

Submit a copy of the affidavit and a copy of your Vaccine Education Certificate to RCDHU via:
• Email: immunization@rcdhu.com (use encrypted email if possible)
• Fax: 613-735-3067
• Mail: 141 Lake Street, Suite 100, Pembroke, ON K8A 5L8
• Drop-off: Weekdays 9:00am–12:00pm & 1:00pm–3:30pm

In the event of an outbreak related to a vaccine preventable disease, any child with a medical, conscience or religious belief exemption on file may be asked to stay home and not attend school until the risk related to the outbreak has ended.

If you have any further questions regarding exemptions, please contact our office at 613-732-9436 or 1-833-773-0004.