Vaccine Information Management System

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Vaccine Information Management System
Online Registration - Minor

NOTE:

If you are vaccinated via Cebu City LGU add your parent/guardian Vaccination ID and Last name for quicker registration. Else proceed with the form below and enter your details manually.

Quick Search

Enter VIMS Cebu Vaccine Card ID No, If Vaccinated Required

Last Name Required

Parent/Guardian Information

Last Name Required

First Name Required

Full Middle Name Please avoid Middle Initial for inconsistencies Leave it blank if no middle name

Suffix Required Choose NA for not applicable

Residency Required

Residency Status Required

Complete Address Required

Home Address Required

Barangay Required

Sitio Required

Contact No. Required eg. 09123456789 - please follow this format

Relationship Required

If Others, Please specify your relationship Required

Is the child living with you ? Required

Agree to have child vaccinated ? Required

Category Required

Last Name Required

First Name Required

Full Middle Name Please avoid Middle Initial for inconsistencies Leave it blank if no middle name

Suffix Required Choose NA for not applicable

Sex at birth Required

Date of Birth Required

Weight in kg Required

Contact No. Required eg. 09123456789 - please follow this format

Complete Address Required

Home Address Required

Barangay Required

Sitio Required

With Allergy ? Required

Choose Allergies Choose at least 1

Drug

Food

Insect

Latex

Mold

Pet

Pollen

Vaccines or Component of Vaccine

With Comorbidities ? Required

Choose Comorbidities Choose at least 1

Bronchial Asthma

Cardiovascular Disease

Hypertension

Kidney Disease

Malignancy

Diabetes

Neurologic Disease

Obesity

Tuberculosis

Immunocompromised State

Others

Please specify your comorbidity Required

In School ? Required

Educational Background ? Required

Are you willing to be vaccinated ? Required

Data Privacy Agreement (For Parents/Guardian)

I hereby certify that the above information are true and correct to the best of my knowledge. I allow the Cebu City Vaccination Operation Center to collect and process my Personal Information and Sensitive Personal Information for the vaccination profiling purposes. The information herein shall be treated as confidential in compliance with the Data Privacy Act of 2012.

You are unable to continue because your data is already in our system.

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