Application for the booster shot (3rd dose) vaccination voucher

1

Input your information
2

Confirmation of your information
3

Completion of the application for reissue

About the Application for the booster shot (3rd dose) vaccination voucher

In case that you have not received a voucher after more than 8 months since your 2nd dose, please apply to re-issue the voucher.
Please be aware that it is especially necessary to apply for the voucher in the case of following:
・if you moved to another city after receiving the 2nd dose
・if you received your vaccination oversea (only for those who have completed 2 doses of Pfizer, Moderna, or AstraZeneca)
・if you received 2 doses of vaccination through the oversea Japanese vaccination service.
* Those who haved NOT completed the 2 doses of vaccination are not eligible for applying for the booster shot (3rd dose).

Some municipalits do not accept your notifications from this page.

How to apply when your city does not accept the application for the voucher from this website.
Please inquiry at the city for the information about the application at the reception of the city, or application by post.

Application for the booster shot (3rd dose) vaccination voucher

Fill out the form below, and click the "Confirm" button to proceed to the confirm page.

Municipality on the certification of residence

Select the prefecture.

Select a city.

The selected municipality is not currently accepting vaccination coupon reissue applications on the COVID-19 Vaccine Navi. For more information, please contact the municipality.

Confirmation

If you received a voucher for the booster shot (3rd dose) from your previous address, please discard it.

Name

First name

Last name

Please enter the last name.

Please enter the last name within 20 characters.

The last name contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Please enter the first name.

Please enter the first name within 20 characters.

The first name contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Date of birth

Please select the year of the date of birth.

Please select the month of the date of birth.

Please select the day of the date of birth.

Please check the date of birth. The selected date does not exist.

Phone number

Please enter the phone number.

Please enter a correct phone number. Please enter 10 digits or 11 digits number beginning with 0.

Please enter the phone number within 11 characters.

The address on the certification of residence

Zip code

Please enter the zip code.

Please enter the zip code with half-width numbers.

Please enter the zip code with 7 charcaters.

Cannot search an address from the zip code.

The address on the certification of residence

Please enter the address.

Please enter the address within 120 characters.

The address contains invalid characters. Please enter with katakana and alphanumeric characters, including punctuation and spaces.

Shipping address
* Only when required

Shipping address * Only when required

Please enter if the shipping address differents from that of your certification of residence.

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Zip code

Please enter the zip code.

Please enter the zip code with half-width numbers.

Please enter the zip code with 7 charcaters.

Cannot search an address from the zip code.

Shipping address

Please enter the address.

Please enter the address within 120 characters.

The address contains invalid characters. Please enter with katakana and alphanumeric characters, including punctuation and spaces.

Name of mansion

Please enter the name of mansion within 40 characters.

The name of mansion contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Reason for notification

If you choose "Others", please enter the reason below.

Please select the reason for notification

Please input the reason for notification if you choose "others".

Please enter the reason for notification within 120 characters.

The reason for notification contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Status of the 1st and 2nd dose of vaccination

The 1st dose of vaccination

Date of vaccination

If the date of vaccinaton is unclear, please fill in with an approximate date.

Please select the year for the date of the 1st vaccination.

Please select the month of the 1st vaccination.

Please select the date of the 1st vaccination.

Please check the date of the 1st vaccination. The selected date does not exist.

Type of vaccination

Please input the vaccine name if you chose "others".

Please select the type of vaccine for the 1st dose of vaccination.

Please input the vaccine name if you choose "others" for the 1st dose of vaccination.

The name of vaccine for the 1st dose of vaccination contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Please enter the name of vaccine for the 1st dose of vaccination within 120 characters.

Method of vaccination

the city who sent the voucher for vaccination

※If you received your vaccination at a mass vaccination site managed by Self-Defense Force, the province, or the city, please select "vaccination at a vaccination site managed by the city, medical facilities, nursing homes, vaccination site at workplace etc.

Please select the method of the 1st dose of vaccination.

Please select the prefecture that sent the voucher for vaccination.

Please select the city that sent the voucher for vaccination.

Please input the method of vaccination if you chose "others" for the 1st dose of vaccination.

The method of the 1st dose of vaccination contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Please enter the method of vaccination for the 1st dose of vaccination within 120 characters.

The 2nd dose of vaccination

Date of vaccination

If the date of vaccinaton is unclear, please fill in with an approximate date.

Please select the year for the date of the 2nd vaccination.

Please select the month of the 2nd vaccination.

Please select the date of the 2nd vaccination.

Please check the date of the 2nd vaccination. The selected date does not exist.

Type of vaccination

Same as the 1st dose of vaccination

Please input the vaccine name if you chose "others".

Please select the type of vaccine for the 2nd dose of vaccination.

Please input the vaccine name if you choose "others" for the 2nd dose of vaccination.

The name of vaccine for the 2nd dose of vaccination contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Please enter the name of vaccine for the 2nd dose of vaccination within 120 characters.

Method of vaccination

Same as the 1st dose of vaccination

the city who sent the voucher for vaccination

Please select the method of vaccination.

Please select the prefecture that sent the voucher for vaccination.

Please select the city that sent the voucher for vaccination.

Please input the method of vaccination if you chose "others" for the 2nd dose of vaccination.

The method of the 2nd dose of vaccination contains invalid characters. Please enter with hiagana, katakana, kanji, and alphanumeric characters, including punctuation and spaces.

Please enter the method of vaccination for the 2nd dose of vaccination within 120 characters.

I agree with the terms of use and privacy policy

You must agree to the terms of use and privacy policy.

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Confirmation of your information

1

Input your information
2

Confirmation of your information
3

Completion of the application for reissue

Input information

Check the input information, and click the "Submit" button.

Municipality on the certification of residence

Confirmation

If you received a voucher for the booster shot (3rd dose) from your previous address, please discard it.

Name

Date of birth

Phone number

The address on the certification of residence

Shipping address

Reason for notification

Status of the 1st and 2nd dose of vaccination

The 1st dose of vaccination

Date of vaccination

Type of vaccination

Method of vaccination

The 2nd dose of vaccination

Date of vaccination

Type of vaccination

Method of vaccination

Application for reissue completed

1

Input your information
2

Confirmation of your information
3

Completion of the application for reissue

Application for reissue has been completed

Please keep this receipt number as it will be necessary for inquiries.
In addition, it will take a certain period of time to issue. Please connect with the municipalities directly if it is urgent.

Apply number:

Apply date:

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