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COVID-19 Forms

COVID-19 - Vaccination Standby Form

This form is for citizens who wish to be placed on a standby list to be contacted at short notice to come for vaccination 

COVID-19 - Vaccination Standby Form

COVID-19 - 'Leave Nobody Behind' form

This form is for citizens who may have missed their invitation for a COVID-19 vaccination. Please fill out this form if you are:

  • Over the age of 12 and have not yet received an invitation for your 1st dose
  • Over the age of 18, it has been more than 8 weeks since your first dose, and you have not yet received an invitation for your 2nd dose
  • In priority groups 1-9, you received your 2nd dose in April 2021 or earlier, and have not yet received an invitation for your booster dose

If you do not fall into any of these groups, but still feel like you have been missed please call us on 02921 841 234, 8am-8pm 7 days a week and we can help further.

COVID-19 - 'Leave Nobody Behind' form

Reschedule COVID-19 Vaccination Appointment

This form is for citizens to be able to reschedule an appointment they have been sent for vaccination at a Mass Vaccination Centre or Community Pharmacy only.  If the appointment is with a GP, the citizen needs to contact the GP Practice to reschedule.

COVID-19 Reschedule Form

COVID-19 Vaccination Opt Out Form

This form is for citizens to be able to inform us that they do not wish to be vaccinated against COVID-19.

COVID-19 Opt Out Form

 

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