Vaccine Adverse Event Report

Please Fill out the form below- You may print it for your records before hitting the send button

Vaccine Adverse Event Report

Take Action Canada has initiated a legal action against all post-secondary school institutions in the province. We need your help formulating accurate statistics about student Covid vaccine injury. This form is confidential and Take Action Canada will not disclose your personal details to anyone.
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Any reaction(s)? A reaction can range from a headache, soreness in arm, brain fog, fatigue, to something significantly more severe and debilitating.
May we contact you?

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