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COVID Vaccine Order - Elgin St. Thomas

48 hours of notice are required to allow for planning.

Please order conservatively and strategically to make the most of each vial and to prevent wastage.

Please ensure you have submitted your weekly fridge monitoring temperatures by fax to 519-633-0468.

Today's Date

Facility, physician or practice name:

Contact Name:

Telephone Number:

Email Address:

How many VIALS of Moderna XBB 1.5 monovalent vaccine do you need? (5 doses per vial)

How many VIALS of Pfizer XBB 1.5 monovalent vaccine do you need? (6 doses per vial)

When do you plan to pick up the vaccine?

When do you plan to administer the vaccine?

Do you have any further comments or questions about your vaccine supply?

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