Please complete the form below and then click SEND.If you do not have a GMS number please enter your PPN number in the box provided.
If yes you are not eligible for the vaccination at this time.
If yes, you will not be eligible for vaccination until four weeks after your Covid-19
If yes, you will not be eligible until vaccine 14 days after your last vaccination.
No action on either yes or no, knowledge transfer to vaccinator.
If yes, you are not eligible for vaccination at this time.If no, but you are more than 14 weeks and less than 33 weeks pregnant and consenting to vaccination, before vaccination happens please discuss the risks and benefits of receiving the vaccine with your obstetric care provider and confirm with them that you are at the correct stage of pregnancy to receive the vaccine.
I consent to receive the COVID-19 vaccination