How to sign the pharmacy vaccine user agreement — and autofill 014-4871-64 with my-id.ca
Enroll injection-trained pharmacies for publicly funded vaccines without retyping pharmacy details
Pharmacies with a registered injection-trained pharmacist requesting publicly funded vaccines for the 2026/2027 immunization period repeat pharmacy legal name, address, licence number, and pharmacist contact on every user agreement. 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: Vaccines and immunization — ontario.ca
- Form (Central Forms Repository): User Agreement for Pharmacies with a Registered Injection-Trained Pharmacist Requesting Publicly Funded Vaccines for the 2026/2027 Immunization Period — 014-4871-64
What this form is about
Form 014-4871-64 is the User Agreement for Pharmacies with a Registered Injection-Trained Pharmacist Requesting Publicly Funded Vaccines for the 2026/2027 Immunization Period — confirm seasonal enrollment rules on ontario.ca.
Before you start: what to gather
- Pharmacy legal name and address.
- Ontario pharmacy licence number and corporation number if applicable.
- Injection-trained pharmacist name, OCP registration, and contact.
- Authorized signatory for the pharmacy corporation.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your pharmacy name, address, and pharmacist contact 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
- Who must sign this agreement?
- Pharmacies with a registered injection-trained pharmacist enrolling for the stated immunization period — confirm on ontario.ca.
- How does my-id.ca help?
- It autofills pharmacy names, addresses, and licence contacts across immunization program forms.
- Is this the same as the UIIP pharmacy form?
- UIIP influenza forms are separate; confirm which vaccines this agreement covers 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.