Additional Information

Last updated May 17, 2024
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 Licensed Injection-Trained Pharmacist Requesting Publicly Funded Influenza Vaccines for the 2024/2025 Universal Influenza Immunization Program (UIIP)
Form File Status Available
Description
Language English
Functionality Fill, Print, and Submit
Form File Content Type Form
Remark
Edition Date 2024-05