Translations of Pre-vaccination Screening Questionnaire for the COVID-19 Vaccine

The Ministry of Health, Labor and Welfare has translated the Pre-vaccination Screening Questionnaire (予診票) for foreigners living in the country. Other COVID-19 vaccine related documents are also available on the official Ministry website.   

[Japanese] 予診票（日本語）.pdf
[English] 予診票（英語）.pdf
[Simplified Chinese] 予診票（中国語 - 簡体字）.pdf
[Traditional Chinese] 予診票（中国語 - 繁体字）.pdf
[Portuguese] 予診票（ポルトガル語）.pdf
[Filipino] 予診票（タガログ語）.pdf
[Thai] 予診票（タイ語）.pdf
[Vietnamese] 予診票（ベトナム語）.pdf 

* Note: Some languages have not been made available yet. Please continue to check the Ministry's website for future updates.  

All translations and additional documents related to the COVID-19 vaccine are available to view as PDFs and for download at the following link:

https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/vaccine_tagengo.html