Your Record Form for Covid-19 Vaccination Clinics
People attending the vaccination clinics for Charlbury Medical Centre patients, must complete a Vaccination Service - Record Form. A PDF of the record form is below.
If you can, please print it double sided. Complete the first two parts and then give your consent to receiving the vaccine. Please remember to take it with you.
When you receive the second dose, please take your vaccination card (small, blue and purple card) with you so it can be updated. For the time being this is the evidence you have been vaccinated.
Thank you for helping to ensure the smooth running of the vaccination clinics.
rural_west_pcn_covid_vaccination_record_form.pdfsusan smith · Fri 19 Mar 2021, 12:59 · Link