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Request COVID-19 Vaccine

register for a COVID-19 vaccine

Please complete the following form to register your interest in receiving a Pfizer mRNA COVID-19 vaccine.

The clinic is following the national rollout schedule, which means everyone in New Zealand aged 16 years and over will be offered a vaccine based on their Group Eligibility:

NOW

Group 1

Border and MIQ workers

NOW

Group 2

High risk frontline workers / those living in high-risk places

NOW

Group 3

People at risk of getting very sick from COVID-19 (over 65yrs OR Māori or Pacific OR have a long-term health condition)

28 July

Group 4

Aged 60 years and over

11 August

Group 4

Aged 55 years and over

TBA

Group 4

Aged 45 years and over

TBA

Group 4

Aged 35 years and over

TBA

Group 4

Aged 16 years and over

COVID-19 Pre-Registration Form

Before filling in the form below, please ensure you have read the Consumer Medicine Information Summary relating to the COVID-19 (COMIRNATY) vaccine here >