Additional Information

Last updated January 27, 2026
Created December 11, 2021
Format application/pdf
Form Number https://forms.mgcs.gov.on.ca/dataset/81101e9c-41cd-4e05-b601-ae35d186191d/resource/f0f4ad84-ef90-4759-a4d3-bc837ac50b99/download/4372-64e.pdf
Form File Identifier 014-4372-64e
Name English - 014-4372-64e - Universal Influenza Immunization Program Reimbursement Form
Form File Status Available
Description
Language English
Functionality Fill, Print, and Submit
Form File Content Type Form
Remark
Edition Date 2025-11