Eligibility:

The purpose of this list is to provide the names and addresses of physicians and clinics which offer ZOSTAVAX™. Consequently, the list of locations includes only clinics and physician's offices which:

• Stock ZOSTAVAX™ onsite
• Administer ZOSTAVAX™ onsite (i.e., at point of storage)
• Are willing to accept new patients for immunization

If you are a physician or clinic and wish to add or remove your name to the list of locations where ZOSTAVAX™ is available, please fill out the information below. A Merck Frosst representative will be contacting you regarding this request to obtain your consent, which is required prior to adding your name to the online list.

 

By filling out this form, you agree to disclose your name and contact information to Merck Frosst Canada Ltd. ("Merck Frosst") and to the general public via the website www.zostavax.ca (the "Website") and you agree to be bound by the following terms and conditions, together with all updates and additional terms, and comply with all applicable laws and regulations. If you do not agree to the following terms and conditions, do not fill out this form.

Your name and contact information will be included in the list of healthcare professionals and clinics which provide the vaccine marketed under the trademark ZOSTAVAX™ (the "List"). The List will be made available to the general public via the Website.

Merck Frosst will not be held responsible for the publication, content or accuracy of any information and content of any nature available on or through the List and the Website (the "Content") and excludes all liability for any reliance placed upon, and for the consequences of any decision taken on the basis of, such Content. Merck Frosst is under no obligation to update the Content and makes no representation or warranty with respect to information and content presented on other sites linked to its Website.