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Order Forms and Pickup of Vaccine

Order vaccine by faxing completed order forms to the local health unit. Contact the local Health Unit with any questions about vaccine ordering.
  • Allow at least 3 working days (Monday to Friday) to fill your order.
  • Vaccine will be distributed based on available products and supply.
  • We will NOT backfill orders. You must reorder.
  • The health unit may contact you if there are questions about the vaccine you ordered.
  • Cold chain must be maintained to ensure potency of the vaccine. Bring a hard-sided cooler with ice packs when picking up vaccine.


Vaccine Order Forms:

All forms are provided in PDF.

South Island (Greater Victoria, Sooke, Saanich, Gulf Islands)


Central Island (Cowichan Valley, Ladysmith, Nanaimo, Qualicum, Port Alberni, west of Port Alberni)


North Island (Courtenay, Campbell River, Gold River, north of Campbell River)