Health Care Provider letter
General fact sheet

Influenza Vaccine Ordering:

Health care provider order form

If you are outside the "M" Postal Code please submit your vaccine order form to your local public health unit.

If your organization is within the "M" Postal Code, submit your vaccine order form via fax to the Ontario Government Pharmaceutical and Medical Supply Services (OGPMSS).

Public hospital letter
General fact sheet

Influenza Vaccine Ordering:

Health care provider order form

If you are outside the "M" Postal Code please submit your vaccine order form to your local public health unit.

If your organization is within the "M" Postal Code, submit your vaccine order form via fax to the Ontario Government Pharmaceutical and Medical Supply Services (OGPMSS).

Data Collection by Ontario Public Hospitals:

Please report your health care worker immunization rates as of November 15, 2011 and submit them to your local public health unit:
Seasonal Influenza Immunization Rates at Ontario Public Hospitals data collection form [WORD DOC]

Depending on the type of influenza immunization clinic (i.e., reimbursable or non-reimbursable) at your hospital please complete the appropriate vaccine utilization form and submit it to your local public health unit:

Non-reimbursable immunization clinic for staff:
Vaccine Utilization Report for non-reimbursable clinics

Reimbursable immunization clinic for the general public:
Vaccine Utilization Invoice for reimbursable clinics

General Information about Non-Reimbursable and Reimbursable Clinics:

For general information about non-reimbursable clinics please review the letter to Regulated Health Care Professionals Holding Non-Reimbursable Clinics.

For general information about reimbursable clinics please review the letter to Regulated Health Care Professionals Holding Reimbursable Clinics.

Long-Term Care Home letter
Fluad® fact sheet
General fact sheet

Influenza Vaccine Ordering :

Health care provider order form

Fluad®:

Long-Term Care Homes will receive their allotment of Fluad® vaccine for residents aged 65 years or older through an autoshipment. This vaccine does not need to be ordered.

Agriflu® and Vaxigrip®:

Please use the health care provider order form or contact your local public health unit to order Agriflu® or Vaxigrip® for the following groups:

• LTCH residents less than 65 years or age;
• LTCH staff regardless of age;
• Retirement home residents or staff regardless of age; or to community clients who attend any community-based clinics offered by the LTCH

If you are outside the "M" Postal Code please submit your vaccine order form to your local public health unit.

If your organization is within the "M" Postal Code, submit your vaccine order form via fax to the Ontario Government Pharmaceutical and Medical Supply Services (OGPMSS).

Data Collection by Long-Term Care Homes:

Please report your health care worker and Long-Term Care Home resident immunization rates as of November 15, 2011 and submit them to your local public health unit:
Seasonal Influenza Immunization Rates at Long-Term Care Homes data collection form [WORD DOC]

Depending on the type of influenza immunization clinic (i.e., reimbursable or non-reimbursable) at your hospital please complete the appropriate vaccine utilization form and submit it to your local public health unit:

Non-reimbursable immunization clinic for staff:
Vaccine Utilization Report for non-reimbursable clinics

Reimbursable immunization clinic for the general public:
Vaccine Utilization Invoice for reimbursable clinics

General Information about Non-Reimbursable and Reimbursable Clinics:

For general information about non-reimbursable clinics please review the letter to Regulated Health Care Professionals Holding Non-Reimbursable Clinics.

For general information about reimbursable clinics please review the letter to Regulated Health Care Professionals Holding Reimbursable Clinics.

Pharmacy letter
General fact sheet

Data Collection and Reimbursement Requirements for Pharmacies:

Vaccine utilization invoice for pharmacies

Available Health Care Agencies:

In order for a pharmacy to host an influenza immunization clinic the pharmacy must retain the services of a health care agency that is located in the same public health unit jurisdiction as the pharmacy and has prequalified with the Ministry of Health and Long-Term Care.

Non-reimbursable letter
General fact sheet

Influenza Vaccine Ordering:

Order form

If you are outside the "M" Postal Code please submit your vaccine order form to your local public health unit.

If your organization is within the "M" Postal Code, submit your vaccine order form via fax to the Ontario Government Pharmaceutical and Medical Supply Services (OGPMSS).

Required Data Collection by Prequalified Organizations:

Please complete a Vaccine Utilization Report after each clinic and submit it to your local public health unit.

Reimbursable letter
General fact sheet

Data Collection and Reimbursement Requirements:

Vaccine utilization invoice

Influenza Vaccine Ordering:

Health care provider order form

If you are outside the "M" Postal Code please submit your vaccine order form to your local public health unit.

If your organization is within the "M" Postal Code, submit your vaccine order form via fax to the Ontario Government Pharmaceutical and Medical Supply Services (OGPMSS).