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Influenza Vaccine Order Form 2024-2025

Delivery Information

Please allow 5 business days for processing. This does not include delivery if you are using a courier.
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: vaccine@ottawa.ca or 613-580-6744.

Please complete all fields.

Healthcare Provider / Institution / Agency Name:

Contact Name:

Office Street Address:

City:

Province:

Postal Code:

E-mail Address:

Office Telephone:

Fax Number:

Please select the vaccine(s) you would like to order:

FluLaval Tetra or Fluzone® Quad (QIV MDV)-Publicly funded for 6 months and older

Flucelvax® Quad or Fluzone® Quad (QIV PFS)-Order for thimerosal allergy

Fluzone® High-Dose Quadrivalent (QIV-HD PFS)-Publicly funded for ages 65 and older

Fluad TIV adjuvant (TIV-adj PFS) – Publicly funded for ages 65 and older

Actual order will depend upon availability of each product.

Delivery by:

Dynacare (Registered participants only)

Bio-Test

Self pick up

On-Demand Courier (delivery within 3 hours)

Please upload your fridge temperature recordings in order to process this order.

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