COVID-19 Vaccine Registration

Thank you for choosing Mediclinic Middle East.

Please fill in the information below to request a COVID-19 Vaccine Appointment (only Sinopharm 2nd Dose).

Mediclinic will follow all the latest COVID-19 Vaccine DOH guidelines.

All fields in the form are mandatory to coordinate your request.

First Name This field is required.

Last Name This field is required.

Emirates ID

Mobile Number This field is required.

Type Of Dose

Hospital / Clinic Name

Date of 1st Dose Taken

Date of 2nd Dose Taken (If requesting for Pfizer 3rd Dose)

I have read and accept the terms and conditions of use.* This field is required.

Please don't fill out this field if you are a human being*

This field is required.