COVID-19 Vaccination Registration Template

Streamline how you gather customer, employee, student, or volunteer COVID vaccine information with this COVID-19 Vaccination Registration Form Template from Formsite. Useful to local health departments, pharmacies, pop-up vaccine locations, churches, educational institutions, and businesses, this vaccine registration form is also fully customizable with our drag and drop editor.

This sample form template gathers all the data you need, including contact information, whether or not the individual is receiving a second dose or booster shot, whether they have a weakened immune system or pre-existing health conditions, or have had any experience or side effects or severe allergic reactions with past immunizations.

Formsite’s extensive form builder and style tools let you quickly and easily customize this template so it meets your exact needs. Once it’s finished, it can be embedded right into your website, or the link emailed or posted to social media. Patients or employees with vaccine appointments can simply view the form with their mobile device, fill it out, and submit it prior to arrival. For walk-ins to your vaccination clinic, use text messaging to send the link upon arrival.

All form data can be sent to other apps, too, including Excel, Word, PDF, Google Suite, and more, so you can send information to the CDC and your local health department.