Ask to be phoned back for an appointment

In order to be eligible for the covid-19 vaccination campaign and use this form, you must be :

  • Monegasque or Monaco resident
  • Aged over 12
  • Undertaking a professional activity in Monaco
  • Being enrolled in school or studying in Monaco

Day / Month / Year

Genuine travel difficulties*
Age range*
Do you undertake a professional activity in Monaco?*

If you don't live in Monaco, a proof of professional activity is mandatory.

Are you enrolled in school or studying in Monaco ?*
Are you pregnant? (2)*

* Mandatory Field

(1) Minors must be accompanied by their legal representative as well as a duly completed authorization, downloadable below



(2) A medical prescription established by a specialist in gynecology and obstetrics is required.