From Oct.1st, we start influenza vaccination.
This season, we introduce online influenza vaccine questionnaire system. You may complete vaccine questionnaire using your computer or smartphone and on the day of your vaccination, we will print it out.
●The flow of the online influenza vaccination questionnaire
1.Please input to the web influenza vaccination questionnaire from your smartphone or PC at home.
2.On the day of your vaccination, we will print your influenza vaccination questionnaire and give it to you.
3.Please fill in your body temperature on the day, confirm the contents, and sign the printed influenza vaccination questionnaire.
※We have received permission from Tsukuba City to use this questionnaire and Tsukuba City residents will be eligible to receive a subsidy for their vaccination if they meet Tsukuba City’s criteria.
※If your address is not registered in Tsukuba or if you move away you will be unable to receive any subsidy.
※This web vaccination questionnaire can only be used at Takezono Family Clinic.
※For inquiries regarding this web vaccination questionnaire, please contact Takezono Family Clinic.
Please access the web influenza vaccination questionnaire by using the link below or by reading the QR code.
●Go to the influenza vaccination questionnaire