Enroll or report as a UIIP pharmacy without retyping pharmacy and pharmacist details

Pharmacies participating in the Universal Influenza Immunization Program repeat pharmacy legal name, address, licence number, pharmacist-in-charge contact, and delivery information on every seasonal pharmacy form. This guide is an example of storing them once in hivi.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Vaccines and immunization — ontario.ca
• Form (Central Forms Repository): Universal Influenza Immunization Program Pharmacy Form — 014-4455-64

What this form is about

Form 014-4455-64 is the Universal Influenza Immunization Program Pharmacy Form, used by participating pharmacies to enroll, order, or report under the publicly funded influenza immunization program for pharmacies — confirm seasonal requirements on ontario.ca.

Before you start: what to gather

• Pharmacy legal name and address.
• Ontario pharmacy licence number and corporation number if applicable.
• Pharmacist-in-charge name, registration, and contact.
• Vaccine order or reporting details for the season — confirm on ontario.ca.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your pharmacy name, address, and pharmacist contact in your hivi profile.
2. Keep documents ready. Upload supporting documents to hivi Files so you are not searching at form time.
3. Autofill the form. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
4. Review and submit yourself through the official channel.

Why do it in hivi

Related Ontario forms repeat the same personal details. Captured once in hivi — stored in Canada, with AI on its own servers — every form starts mostly complete.