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Thank you for participating in the Immunization Survey.

The survey will take 10 to15 minutes.

You will need your child’s health card and your child’s immunization record (print out or yellow card).
Your information will be kept private.

Press "next" once you have completed your response.
Press "back" at any point to return to the previous question.
Press "start over" if you wish to restart the survey.
Press "continue survey later" if you need to stop during the survey:you can continue the survey later.

If you have any difficulties during the survey, please email ImmunizationSurvey@nshealth.ca or call 1-844-996-0694.

Please start the survey now by entering your child’s Health Card Number (HCN) and your child’s Date of Birth.

HCN # : 
Child's Date of Birth :