Form Builder

Required fields are marked with asterisks (*)

Influenza Vaccine Order Form 2021-2022

*Your fridge temperature recordings must be included for this order to be processed

Delivery Information

  • Please allow 2-3 business days for processing. This does not include the delivery time if you are using a courier to deliver your order.
  • If you are using Dynacare (registered participants only) or Bio-Test, you can expect automatic delivery of your order.
  • If you are using Self-pick up or On-Demand Courier, you will receive a phone call when your order is ready. Please arrange to retrieve your order within 48hrs of notification.
    Please bring a cooler and ice packs when picking up vaccine.
  • Vaccine Program hours are Monday to Friday, 8:00am to 4:00pm.

Questions and comments regarding your order may be directed to: or 613-580-6744

Please complete all fields:

*Actual order will depend upon availability of each product.


Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Contact Us