Canada Vigilance Postage Paid Label

You can send your adverse reaction report free of charge by mail to the Canada Vigilance Program by downloading the postage paid label and affixing it to a standard size blank envelope. Reporting forms and postage paid envelopes are also available upon request by contacting a Canada Vigilance Regional Office. For more information on how to report an adverse reaction to Health Canada, visit the Adverse Reaction Reporting section.

Help on accessing alternative formats, such as PDF, MP3 and WAV files, can be obtained in the alternate format help section.

Canada Vigilance Postage Paid Label

Help with the postage paid label

To view, complete, and print the PDF fillable forms, or to download blank forms, you need Adobe Acrobat Reader version 4.05 or higher. This software can be obtained free from the  Adobe Web site.

Follow these simple instructions to create a postage paid envelope to send your completed adverse reaction report to the Canada Vigilance Program.

1. Print the prepaid label on regular paper stock.
2. Cut and carefully glue the outer edges of the prepaid label onto an envelope.
3. Enclose your completed adverse reaction report in the envelope.
4. Mail to the Canada Vigilance Program

Sample of postage paid label
(Artwork not to scale)
Sample of postage paid label affixed to envelope	Sample of incorrectly applied postage paid label