Vaccination Subsidy Scheme - Download Useful Forms (Medical Practitioners)

2023-11-22

The below forms are provided for enrolled medical practitioners.

To enrol in the Vaccination Subsidy Scheme (VSS), please refer to the Enrolment Page.

Note: Subsequent to the updated recommendations of The Scientific Committee on Vaccine Preventable Diseases, Vaccination Subsidy Scheme will cover secondary school students or Hong Kong residents aged below 18 as an eligible group starting from 10 November 2022. (https://www.info.gov.hk/gia/general/202210/21/P2022102100439.htm)

Application / Request / Notification Forms

Other Forms

2023/24 Vaccination Subsidy Scheme Price Poster
Notice on eConsent under the Vaccination Subsidy Scheme
"Consent to Use Vaccination Subsidy" Form 2023/24

Vaccination Record Card
Health Assessment Form and Vaccination Record (PDF Format) (Word Format)
Sample Medical Certificate for Persons with Intellectual Disability under Vaccination Subsidy Scheme 2023/24 (PDF Format)
Sample Certificate Issued by Designated PID Institution for Persons with Intellectual Disability to use subsidy under Vaccination Subsidy Scheme 2023/24
- Single Person
- Multiple Persons
Vaccination Subsidy Scheme Declaration Form for Persons Receiving Standard Rate of "100% Disabled" or "Requiring Constant Attendance" under Comprehensive Social Security Assistance Scheme
Temperature Record of the Vaccine Storage Refrigerator
Temperature Excursion Incident Report Form For VSS (PDF Format)
Clinical Incident Notification Form (PDF Format)