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COVID-19 Related Vaccine Order Form

Please use this survey to request the vaccines once the approval has been granted by OPH.

For current processing times, please refer to our website Ottawa Public Health.

If you have any questions, please send an email to

Please note that supplies are no longer available to order

Staff person designated to act as the contact for Ottawa Public Health for this vaccine event


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To minimize wastage of the vaccine while continuing to vaccinate all those who are eligible, please only order the amount of vaccine required to meet your needs.

Your order will be delivered using your courier if you have one, otherwise we will contact you to pick up the vaccine.

Please enter clinic delivery handler/receiver contact information in the following fields:

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