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Forms – Québec's compensation for victims of vaccination program

Form

Image for document cover.

Description

A claimant must print the forms below; fill them out, providing all information requested; and send them to the following address:

Ministère de la Santé et des Services sociaux
Direction de la protection de la santé publique
Programme d'indemnisation des victimes d'une vaccination
1075, chemin Sainte-Foy, 11e étage
Québec (Québec) G1S 2M1

The forms can also be obtained by calling 1 855 881-9869.

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(PDF, 576 Ko, 10 pages)

This publication is available only in an electronic version.

This publication is available in French.

Details

Online since: July 16, 2013
Last modification: October 23, 2015

Author: MSSS

Publication no : 15-form-indemnisation-en

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