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Relaxation & Stress Management Skills - 3 Sessions
Rural Care Partner Support Group
The Highs & Lows of Diabetes
The Mediterranean Diet for Good Health
Understanding Pre-Diabetes
Walk-Fit Class
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COVID-19 at EWFHT
Clinic Hours
Fees & Services
Health Card FAQs
Physicians Accepting New Patients in Our Area
Healthcare Options In Your Community
Online Booking
Prescriptions
Ticks
Saturday Urgent Care
Other Clinics
What's New in Healthcare!
Zero Tolerance Policy

Flu Shot or COVID-19 Vaccination Elsewhere

If you did not receive a flu shot or COVID-19 vaccination at your family doctor's office, please let us know where you received it and the (approximate) date.  (Only complete relevant answers, leave others blank.)

Name:
Date of Birth (DD-MM-YYYY):
I received my flu shot at:
Approximate date of flu shot (DD-MM-YYYY):
I received my COVID vaccination at (location):
Approximate date of COVID vaccine (DD-MM-YYYY):
I received:
Dose 1
Dose 2
The type I received is:
AstraZeneca
Moderna
Pfizer
Other/Unsure
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Unit 1 • 6 Thompson Crescent • Erin ON N0B 1T0 • Phone: (519) 833-9396
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