What a naloxone requisition asks for — and how to autofill 014-4901-97 with my-id.ca
Order publicly funded naloxone supplies without retyping pharmacy or organization details
Pharmacies and organizations requisitioning naloxone kits repeat legal name, site address, authorized contact, and delivery details on every ministry requisition. This guide is an example of storing them once in my-id.ca.
Official form and source
Start from the official source and always use the current version — form numbers and links can change:
- Service page: Ontario take-home naloxone kit programs — ontario.ca
- Form (Central Forms Repository): Requisition for Naloxone — 014-4901-97
What this form is about
Form 014-4901-97 is the Requisition for Naloxone used by eligible pharmacies and organizations participating in Ontario's publicly funded naloxone programs to order kits or supplies — confirm whether your program uses this form on ontario.ca.
Before you start: what to gather
- Pharmacy or organization legal name and site address.
- Authorized contact name, phone, and email.
- Program participation details (for example ONPP) — confirm on ontario.ca.
- Quantities and product types requested.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your organization name, site address, and contact details in your my-id.ca profile.
- Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
- Autofill the form. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
- Review and submit yourself through the official channel.
Why do it in my-id.ca
Related Ontario forms repeat the same personal details. Captured once in my-id.ca — stored in Canada, with AI on its own servers — every form starts mostly complete.
Frequently asked questions
- Do all pharmacies use this form?
- Many ONPP pharmacies procure kits through suppliers — confirm whether 014-4901-97 applies to your program on ontario.ca.
- How does my-id.ca help?
- It autofills organization names, addresses, and contacts across public health requisitions.
- Can individuals use this form?
- This requisition is for participating organizations — individuals receive kits at distribution sites listed on ontario.ca.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.