Vaccine Provider Registration Form & Ordering

Information for Health Professionals

For the 2023-2024 Influenza Immunization Program all community providers (excluding community pharmacists and community physicians) will receive the Influenza Program Letter which outlines all aspects of the Influenza immunization program. Some Zones will still be utilizing the Influenza Program Registration Form. This registration form provides the basic information needed to provide your site with influenza vaccine. Providers are asked to complete this form in order for the Alberta Health Services (AHS) Zone Contact to obtain accurate accounting of the number of partners participating in the influenza immunization program.

Community Physicians

Community physicians participating in the influenza immunization program will receive influenza and pneumococcal-23 vaccines from the wholesale distributor, Accuristix in collaboration with Alberta Health (AH), and order through the Alberta Vaccine Inventory (AVI) system.

Medical clinics that have already registered in AVI do not require additional registration and will be able to order influenza and pneumococcal-23 vaccine through Accuristix starting September 1, 2023. Medical clinics that have not registered in AVI and wish to participate in the influenza immunization program for the 2023-2024 influenza season, can register through the AVI webpage.

Questions or concerns can be directed to health.imm@gov.ab.ca.

Note: this includes physician offices who have offered influenza vaccine to their patients in past seasons and have AVI access to order vaccine through AHS.

Please use the form in the link below to submit the required information for registration into AVI. Physician Clinic Registration/User form.