Immunization and Communicable Disease Form

Students in the programs listed below need to complete and file with us their completed Immunization and Communicable Disease Form as soon as possible prior to their work placement term.

• CDS Form(opens in new window)
• BW Requisition(opens in new window)

Mail or fax your complete health record to:

• Confederation College Health Centre-REACH BUILDING
  1450 Nakina Drive
  Thunder Bay, Ontario
  P7B 0E5
  Fax: (807) 473-3706

Programs or Courses with a Work Placement component that need to complete this form include:

Health Sciences and Community Services

• Aboriginal Community Advocacy
• Dental Hygiene (*hb Mandatory)
• Developmental Services Worker (*hb)
• Early Childhood Education
• Medical Laboratory Assistant (*hb Mandatory)
• Medical Radiation Technology (*hb Mandatory)
• Paramedic (*hb Mandatory)
• Personal Support Worker (*hb Mandatory)
• Practical Nursing (*hb Mandatory)
• Recreation Therapy - year 2
• Social Service Worker - year 2
• Social Service Worker

Distance Education Programs:

• Autism & Behavioural Sciences

(*hb) In addition, those programs above marked with an (*hb) designation:

1. Hepatitis B is mandatory for Paramedic, PN, PSW, MRT, MLA and Dental students.
2. Influenza-vaccination against influenza for those working in health related fields is strongly recommended. If there is a flu outbreak on your clinical placement site and you cannot provide proof of having received a current flu shot, you may not be allowed to continue your placement.