NPHCDA COVID-19 Website

Registration
Corporate Vaccination
Vaccination Sites

Verification Portal

English Yoruba Igbo Hausa

Registration Form for COVID-19 Vaccination

Last name (Surname)

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First name (Given Name)

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Middle name

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Email address

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Contact phone number (Please enter a relative's no if you do not have one)

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Confirm your phone number (re-enter phone number)

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Is the exact Date of Birth known?

Yes

Enter your approximate age

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Date of birth

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Type of ID

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Sex

Male

Female

Are you pregnant?

Yes

Residential Address

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Work information

Do you work in the Health Sector?

Yes

Are you a front-line worker?

Yes

What is your occupation? (Please select your occupation)

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Front line health workers (Private or Public Sector)

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What is your occupation? (Please select your occupation)

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Health History Information

Any known medical condition?

Yes

Select condition(s)

Heart disease

Kidney Disease

Liver Disease

Sickle Cell

Hypertension

Chronic Obstructive Pulmonary Disease (COPD)

Diabetes/Diabetic complications

Schedule information

Preferred Health Facility type

Public

Private

Preferred State for Vaccination (Select the State where you would like to receive your vaccine)

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Preferred LGA for Vaccination (Select the LGA where you would like to receive your vaccine)

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Preferred vaccination site (Select the vaccination site where you would like to receive your vaccine)

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Select your preferred date for vaccination (Select from the available vaccination days for your vaccination site)

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Select your preferred time slot (Select from the available time slots for your vaccination site)

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Vaccination Information

Have you taken first dose?

Yes

Thanks, a member of our team will be in touch shortly.

Please fill all fields correctly.

Electronic Management of Immunization Data (EMID)

Registration Portal

This is the registration platform of the Federal Ministry of Health for COVID 19 Vaccination.

It captures your data and schedules you for COVID 19 vaccination.

Registering here will make your vaccination easier and faster.