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Registration of Interest If you have yet to receive your COVID-19 Vaccination and wish to avail of a pharmacy appointment, complete this form to be notified of vaccine availability from your nearest participating Mangan’s Pharmacy. The pharmacy team will contact you if they can offer you an appointment. Please click here for to see the HSE COVID – 19 booklet.

Please note: Completion of this form does not guarantee vaccine availability or eligibility. Participating pharmacies, and which vaccines they can administer, are determined by the HSE. The recommended age-groups for each vaccine is subject to change by the HSE; please monitor the HSE website,( https://www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/) news and social media for updates.

Registration for people under the age of 16 years must include the name of a parent or legal guardian who will accompany them to a vaccine appointment to provide the necessary consent. After you register, please remember to contact the pharmacy if you secure an appointment elsewhere so they can remove you from their waiting list.

 

Complete this form with the details of the person requesting vaccination