Procedures for Yellow Fever Vaccination Centres in Canada
Yellow Fever Vaccination Centres
For Health Care Sites
Forms: Yellow Fever Vaccination Centres in Canada
Please note that all forms are available in PDF format only. Please ensure to save on and download the PDF file to your desktop. Then open the file using Adobe Reader from your desktop. To inquire about receiving these documents in another format, please contact us. If you do not have PDF viewing software, you can download a free PDF viewer from the Adobe® Web site.
To apply to become a Yellow Fever Vaccination Centre:
- Application form (PDF document - 162 KB - 2 pages)
- Attestation form (PDF document - 121 KB - 1 page)
* Please attach a copy of the Nominated Health Care Practitioner’s current license to practice when submitting the application.
To notify us of changes to an existing Yellow Fever Vaccination Centre:
Change to address of health care site:
Change to Nominated Health Care Practitioner:
- Notification of changes form (Section C) (PDF document - 144 KB - 2 pages)
- Attestation form (PDF document - 121 KB - 1 page)
* Please attach a copy of the Nominated Health Care Practitioner’s current license to practice when submitting the application.
To order copies of the International Certificate of Vaccination or Prophylaxis, or the Certificate of Medical Contraindication to Vaccination:
To terminate the designation of a Yellow Fever Vaccination Centre:
Please return by mail all certificates and stamps issued by the Public Health Agency of Canada.
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