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  • Writer's pictureBen M

COVID-19 Vaccination Screening Form

If you have your vaccination coupon, you can download, print and complete this form to give to the hospital/clinic you are visiting to receive your vaccination.

Please note, that you will be required to complete the Japanese language form, so please use any other files as a translation guide.

Prevaccination Form - Japanese
Download PDF • 364KB

Prevaccination Form - Chinese
Download PDF • 368KB

Prevaccination Form - Vietnamese
Download PDF • 329KB

Prevaccination Form - English
Download PDF • 249KB

Prevaccination Form - French
Download PDF • 252KB

Prevaccination Form - Korean
Download PDF • 421KB

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