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When we are vaccinated with medical institution in the suburbs

Last update date July 19, 2019

How to receive Vaccinations with medical institution of the suburbs

Please consult with ward office Health Promotion Section of ward to live beforehand if you would like to be vaccinated by convenience in municipality except Yokohama-shi.
When we are vaccinated, based on vaccination, we issue "request for immunization practice book" which is documents which made that The Mayor of Yokohama has the conduct responsibility clear by medical institution of the suburbs.
In addition, as for the inoculation expense, principle is paid privately.

We can receive refund (we get rid of repayment) of expense to modify inoculation by having you do necessary/required procedures beforehand when we are vaccinated by the next unavoidable circumstances regularly in the suburbs after April 1, 2013.

・Homecoming childbirth (but to under four months after birth) in the suburbs
・Under hospital care in hospital in suburbs (but is limited to Vaccinations of child)

Application for request for immunization practice book method

You print out 1 "request for immunization practice book issuance application", and please fill in required items.

(application is put in Health and Welfare Center.)
"Request for immunization practice book issuance application" paper print (PDF: 75KB)

Please submit 2 "request for immunization practice book issuance application" to Health and Welfare Center Health and Welfare Division Health Promotion Section of Address place.

By telephone, FAX can apply. (Contact information of each ward Health and Welfare Center

After accepting application in 3 Health and Welfare Center, we issue Vaccinations request book and see to destination (accommodation Address, accommodation municipalities office) you like.

(it takes approximately 1-2 weeks until application acceptance - shipment.)

Please fill in attention entry column 1-10 at the time of application entry.

Please fill in the name, furigana of person receiving 1 cover inoculator full name Vaccinations.
Please fill in the date of birth of person receiving Vaccinations on 2 date of birth.
Please fill in zip code, Address, Phone number of Yokohama-shi with 3 Address resident certificate.
Please fill in the name of protector of person receiving 4 protector full name Vaccinations and relation with vaccinated person.
In the case of application, other than 5 applicant full name protectors, please fill in full name and relations with vaccinated person.
About reason issuance reason of 6 issuance, send circle (or check) with applicable number, as needed item
Please list.
Please add ○ to Vaccinations which wish to issue type Vaccinations request book of 7 Vaccinations.
Of medical institution (or public health centers) which is going to receive inoculation on scheduled scheduled 8 inoculations date, medical institution inoculation date
Please fill in name, Address, doctor name.
When you are staying any place other than 9 accommodation Address present address, please fill in zip code, Address, Phone number of accommodation.
When you issue request for 10 book destination request book by mail, please choose destination.

Adobe Acrobat Reader DC (old Adobe Reader) is necessary to open file of Portable Document Format.
Person who does not have can download free of charge from Adobe company.
Get Adobe Acrobat Reader DCTo downloading of Adobe Acrobat Reader DC

Inquiry to this page

Health and Social Welfare Bureau health security department health security section

Telephone: 045-671-4190

Telephone: 045-671-4190

Fax: 045-664-7296

E-Mail address [email protected]

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