Page 1: Please read the following information before continuing to the form

As part of the COVID response we are collecting information about our staff to offer a COVID vaccination. We will only use the data you provide on this form to validate against what we hold and then invite you to book an appointment for a COVID vaccination. You will have the opportunity to decline or ‘opt out’ of the appointment once it is received.

It is important that you complete this online form even if you feel you do not wish to receive the COVID vaccination at this time.

We will hold this data in a secure environment on the organisation's computers. We will use the data to provide analytical information to the Health Board and partners such as, the percentage and number of people who have responded. It is important to note that we will only use this information to create and invite you to book an appointment.

Thank you for your time and support.