COVID-19 Booster Vaccination Form

       

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* This page is about the XNUMXrd pre-examination slip.
Click here for the XNUMXst and XNUMXnd pre-examination slips

 

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This is the third pre-examination slip for COVID-19.Please use these as a reference.

 

 

⚠Caution⚠
Please be sure to write on Japanese paper.Paper that is not in Japanese cannot be used.

 

 

◆ Português ◆

 

◆ Tagalog ◆

 

◆ English ◆

 

Preliminary examination slip written in various words(Move to the page of the Ministry of Health, Labor and Welfare)

 

⚠Caution⚠
Please be sure to write on Japanese paper.Paper that is not in Japanese cannot be used.

 

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Contact
● Toyohashi City New Corona Vaccine Call Center
NUM0570-09-5670

 

About the call center

 

 

Contact Form
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