COVID-19 Vaccine Order Form for Vaccine Providers

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Public and private sector health care providers authorized to order a supply of the COVID-19 vaccines from the PEI Chief Public Health Office will be issued an access code to complete the online form below.  Any health care service administering the COVID-19 vaccine in PEI must comply to the COVID-19 Immunization Policy 2021.

If you are ordering more than one type of vaccine, you will need to complete a separate order form for each one.

What do I need to complete the online form?

You must enter the password issued through CPHO to access the form. Then you will be asked to:

  • Provide identification and contact details for your clinic and the individual responsible for the care and control of the COVID-19 vaccine supply issued to you; 
  • Identify the vaccine type and quantity doses you are ordering, i.e. Pfizer-BioNTech, Moderna, AstraZeneca/Covishield; and
  • Acknowledge that you have read and are able to comply with the COVID-19 Immunization Policy 2021 which includes your commitment to report each COVID-19 vaccine administered in accordance with the Public Health Act Immunization Regulations

How long will it take to process my order?

Please submit your order 3-5 days before the clinics begin.

Santé et Mieux‑être

Renseignements généraux

Ministère de la Santé et du Mieux-être
Immeuble Shaw, 4e étage (nord)
105, rue Rochford
Charlottetown (Î.-P.-É.) C1A 7N8

Téléphone : 902-368-6414
Télécopieur : 902-368-4121