Get Order Form For Publicly-funded Vaccine

This guide provides detailed instructions on completing the Order Form for Publicly-Funded Vaccine online. Following these steps will help ensure that your order is processed efficiently and correctly.

Follow the steps to fill out the order form accurately.

1. Click ‘Get Form’ button to obtain the form and open it for filling out.
2. Enter the order date in the format yyyy/mm/dd. This is the date you are submitting the order.
3. Input the desired pick-up date on the form, also in yyyy/mm/dd format. Ensure this date allows for 2 business days from the order date.
4. Fill in the facility name where the vaccines will be picked up. This should be the official name of the healthcare facility.
5. Provide the names of health care providers associated with this order. List all relevant providers to ensure complete identification.
6. Include the contact name of the individual responsible for this order. This person will be accessible for any follow-up.
7. Enter a valid telephone number for the contact person listed. Make sure that this number can receive calls or messages regarding the order.
8. Ensure that temperature logs are faxed with this order for the period since your last vaccine order; otherwise, the vaccine will not be released.
9. Remember to pick up the vaccine between 8:30 am and 4:30 pm, bringing your insulated cooler with ice or gel packs.
10. Verify that you are keeping under a 1 month supply of vaccines in your fridge and use the Vaccine Return Form for any returns.
11. Store vaccines between 2˚C to 8˚C. If any temperatures are outside this range, call Health Unit at 743-1000 immediately.
12. After completing the form, review all entries for accuracy and save changes. You can download, print, or share the form as needed.

Complete your order form online today to ensure timely processing of your vaccine request.