Vaccination Pre-Registration

Personal Information
Important Note for A2. Senior Citizen
  • Please bring your Senior Citizen [OSCA] ID during your vaccination schedule.
Important Note for A3. Adult with Comorbidities
  • Bring any required proof documents like: Medical Certificate, Doctor's Prescription for your maintenance, Hospital Records (discharge summary, Medical Abstract, Surgical Record or Pathology Report and others) during your vaccination schedule.
Important Note for A4. Frontline Personnel in Essential Sector
Important Note for Pediatric A3
Current Address
Clinical Information

By clicking "Submit," I hereby attest that the above information is true and hereby authorize the City Government of Surigao to collect and process the data indicated herein for the purpose of vaccination pre-registration. I understand that my personal information is protected by RA 10173, the Data Privacy Act of 2012.