A-Z List | Accessible Info | Careers | Contact Us

 
 

Communicable/Reportable Diseases

Influenza, Rabies, STIs, TB, other
public health > health professionals > influenza vaccine order request 2017/2018

Influenza Vaccine Order Request 2017/2018

You must provide an email address for online orders so that we can send you a confirmation email for receipt of your order.

For questions about completing this form, please contact the Vaccine Order Desk at 905-791-7800 ext. 6404.

Before filling out this request, please confirm:




Order Information
(*) Mandatory fields
RMP_MS_


















Yes No

Ext.



Delivery or Pick-up Preference (Select One)

FREE DELIVERY IS AVAILABLE FOR A LIMITED TIME


Orders must be picked up within 3 business days of phone call from Peel Public Health.




Type of Refrigerator

Please indicate the number of refrigerators approved for storage of influenza vaccine:



* Please order no more than a ONE month supply of vaccines

Note: Provide current stock of ALL flu vaccine product in fridge.

Note: Due to the high demand of practitioners ordering vaccine, all orders may be reduced. Product type will be dependent on vaccine availability from the Ministry of Health and Long-Term Care (MOHLTC).

Influenza Vaccine Vaccine Formulation Eligibility Product Description
Fluviral® TIV 6 months and older, but preferred for those 18 years and older Multi-dose vial
* Current Stock
# of doses Required Vaccine must be ordered in increments of: 10
Unavailable for now
 
Influvac® TIV 3 years and older, but preferred for those 18 years and older Single dose syringe
* Current Stock
# of doses Required Vaccine must be ordered in increments of: 10
 
FluLaval® Tetra /
Fluzone® Quadrivalent
QIV 6 months to less than 18 years of age Single dose syringe / Multi-dose vial
* Current Stock - Pre-Filled Syringe
* Current Stock - Multi Dose Vial
# of doses Required Vaccine must be ordered in increments of: 10
 
Flumist® Q-LAIV 2 years to less than 18 years of age Intranasal spray
* Current Stock
# of doses Required Vaccine must be ordered in increments of: 10
Unavailable for now
 
Vaccine Related Supplies Quantity:
Quantity:
Quantity:

If you have been notified by Peel Public Health to submit temperature logs with your vaccine orders, please ensure that temperature logs spanning from your last order until today are faxed to 905-565-9874 or emailed to us at VMPIOrderRequest@peelregion.ca.


Peel Public Health Home | Tools | Alerts | Events

Revised:November 10, 2017

www.peelregion.ca

Home | Contact Us | Search | A-Z Topic List
Privacy & Terms of Use | Service Commitment

Smaller Text Larger Text