COVID-19 Vaccination

Registration of Interest

You will need to bring identification with you to the pharmacy at the time of your appointment.

* Denotes required field

Please note: Completion of this form does not guarantee vaccine availability or eligibility. The recommended age-groups for each vaccine is subject to change by the HSE; please monitor the HSE website, news and social media for updates.

Privacy Notice: By completing this form, you agree that your information will be sent to Laois Pharmacy, who will use the details you provided to contact you and organise an appointment if available.