ONLY USE THIS FORM TO REQUEST AN APPOINTMENT FOR A FIRST, SECOND OR BOOSTER VACCINATION IF YOU ARE REGISTERED WITH THE CRANBORNE PRACTICE INCL LAKE ROAD SURGERY.
Last Updated: 22/12/2021
About the patient
So we can link this request with our patient records.
REQUEST FOR COVID-19 VACCINATION
We are now able to provide our patients with COVID vaccinations at the Crane Valley PCN site in Verwood, 131 Newtown Road, BH31 6EH.
Please complete the details below and we will email you with the next available appointment.
PLEASE NOTE THAT PATIENTS AGED 18 (plus 28 days) AND OVER WHO HAVE TESTED POSITIVE FOR COVID-19 WILL NEED WAIT AT LEAST FOUR WEEKS FROM THE DATE OF INFECTION BEFORE RECEIVING THEIR NEXT DOSE. PATIENTS AGED 12 - 18 WILL NEED TO WAIT FOR 3 MONTHS.
HOW MAY WE CONTACT YOU?