Additional Information

Last updated	May 12, 2026
Created	December 11, 2021
Format	application/pdf
Form Number	https://forms.mgcs.gov.on.ca/dataset/47444c27-acc1-449d-bcba-ebad81889d52/resource/6d08f2a0-144c-49fe-908a-41c513d61a11/download/4871-64e.pdf
Form File Identifier	014-4871-64E
Name	English - 014-4871-64e - User Agreement for Pharmacies with a Registered Injection-Trained Pharmacist Requesting Publicly Funded Vaccines for the 2026/2027 Immunization Period
Form File Status	Available
Description
Language	English
Functionality	Fill, Print, and Submit
Form File Content Type	Form
Remark
Edition Date	2026-05