Vaccine Provider Registration Form & Ordering

Information for Health Professionals

For the 2024-2025 Seasonal 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

Questions about vaccine distribution to physicians and primary care clinics are best directed to Alberta Health.