VACCINE INJURY FORM SUBMISSION

Please click here to learn more about our Vaccine Injury Initiative!


"Informed Consent" (As defined by the Canadian Medical Protective Association):

  • ​The patient must have been given an adequate explanation about the nature of the proposed investigation or treatment and its anticipated outcome as well as the significant risks involved and alternatives available.

  • The obligation to obtain informed consent must always rest with the physician who is to carry out the treatment or investigative procedure.

Do you feel you were adequately educated, as to the risks, benefits and alternatives, as to provide informed consent, prior to receiving the vacccine? (See top of form for definition of informed consent)
Has a medical professional confirmed that the injury/injuries is a direct result of the vaccination?
Do we have your consent to share your story? This could include, but is not limited to, class action suits, news articles and/or documentaries.
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Thank you for your request. We Unify Canada is a volunteer organization. We will address requests in the order in which they are received. We appreciate your patience.