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help with vaccines (COVID or flu)

This form is for you if you are looking to book a vaccine appointment for COVID or flu, and require further assistance. 

NOTE: We are running a COVID vaccine clinic,

this Friday Apr21/2023 from 10am-4pm.

My name is:
My health card number is:
I need:
a COVID vaccine (note we only have the Pfizer bivalent vaccine, intended as a booster)
Yes No
a flu shot
Yes No
Please contact me by:
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Copyright 2023 Credit Valley FHT
Copyright 2008 - 2023 FHT Solutions.All rights reserved
Suite 101 • 2300 Eglinton Ave West • Mississauga ON L5M 2V8 • Phone: (905) 813 3850