Medix Brampton – Yes-Symptoms No-Vaccinated – Medix College

Based on your response, you are not vaccinated (or partially vaccinated) and you have symptoms. Do not visit the campus. Please fill out the form to receive instructions.

Vaccination Status (required)

Do You Have a Medical Exception(required)

Have You Completed The Vaccination Education Video (required)

Have You Completed Your Weekly Rapid Test with a Negative Result (required)

Your First Name (required)

Your Last Name (required)

Your Email (required)

Your Phone Number (required)

Date (required)

Arrival Time (required)

Medix Campus (required)

Reason for Visit (required)

Covid Symptoms Screening