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French Community Covid-19 Vaccination Programme Registration for children 12-17-year-old

Joint Commission International
Gold Seal of Approval ®

Children of French citizens and students of the Lycée Marguerite Duras can now register to be vaccinated against Covid-19 at FV Hospital.

For parents with several children in age to be vaccinated:

  • Each child must be registered separately, do not try to register all your children on one form
  • Use the same email address for all of them
  • To allow us to put the appointments at the same time please indicate the name of the other children you already have registered or are going to register.
Justificatifs à fournir

Required documents

Giấy tờ cần cung cấp

1) Acte de naissance/ Birth certificate/ Giấy khai sinh

ou/ or/ hoặc Livret de famille/ Family book/ Sổ hộ khẩu

2) Copie du passeport de l’enfant/ Passport copy of your child/ Bản sao hộ chiếu của trẻ

3) Formulaire d’autorisation parentale complété et signé/ Consent form completed and signed / Phiếu chấp thuận tiêm vắc xin có chữ ký của phụ huynh

Cas particuliers (parent décédé, parents divorcés)

Special cases (deceased parent, divorced parents)

Các trường hợp đặc biệt (cha mẹ qua đời, cha mẹ ly hôn

Acte de décès ou jugement de divorce / Death certificate or divorce certificate/ Giấy chứng tử hoặc giấy ly hôn
En cas de difficultés, vous pouvez écrire à l’adresse suivante : admin-francais.ho-chi-minh-ville-fslt@diplomatie.gouv.fr

In case of difficulty, you can write to: admin-francais.ho-chi-minh-ville-fslt@diplomatie.gouv.fr

Trong trường hợp cần hỗ trợ, vui lòng liên hệ: admin-francais.ho-chi-minh-ville-fslt@diplomatie.gouv.fr

Are you already registered with FV?  
Even if you are already registered at FV Hospital please provide again the information below as we need to make sure it's current and valid
if NO, please fill in the information below
Personal information
Incorrect HN
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required Please enter the valid email
* This field is required
The confirmation email must match your primary email address
* This field is required Incorrect Mobile phone number
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required Please enter the valid email
* This field is required
The confirmation email must match your primary email address


Current Resident Address
* This field is required
* This field is required
* This field is required
* This field is required
* This field is required
In Case of Emergency
* This field is required
* This field is required Incorrect Mobile phone number
Medical Insurance
Occupation
Please upload photo(s) of the following documents

Download the informed consent form

Only .jpeg .jpg .png .pdf are allowed. File must be less than 3MB

Do you want your child to come for vaccination with other family members?

If YES, please indicate your eligible family members to help us managing appointments.

  • Family Member 1
  • Family Member 2
  • Family Member 3
  • Family Member 4

You will be contacted shortly to give you an appointment date and time. Please bring with you the documents listed above, as we must check them before the vaccination.

You may not be contacted immediately by FV Hospital, be patient and please do not register your child/children a second time

In the meantime, it is recommended that you read carefully the patient information brochures on Moderna Covid-19 vaccine that you can download from this website

Moderna Covid-19 vaccine

How Moderna’s Vaccine Works

For consultations, kindly contact our Call Centre

 Hotline: (028) 54 11 33 33

 Monday – Friday: 08:00 — 17:00

 Saturday: 08:00 — 12:00

 Sunday & Public Holiday: Closed