Solaire IFI Vaccination Center

TERMS AND CONDITIONS

 for the Solaire-IFI Nayong Pilipino Vaccination Center & Solaire-IFI Vaccination Center

These Terms and Conditions, along with the Privacy Statement and the Terms and Conditions for Data Sharing which is provided hereto as Annex “A”, constitute the agreement between ICTSI Foundation, Inc. (“Foundation”) and the entity indicated in below (“Agreement”), duly represented by its authorized signatory for the use of the Solaire-IFI Nayong Pilipino Vaccination Center, Paranaque City & Solaire-IFI Vaccination Center, Solaire Resort (“Inoculation Sites”) to administer the Moderna Inc.’s mRNA COVID 19 vaccine (“vaccine”).

A.        GENERAL PROVISIONS:

1. “You" shall mean the individual or company whose name is indicated below, including the company/ies or individual/s such named individual or legal entity likewise represent, and where applicable, including subsidiaries, affiliates, assignees, as well as its officers, directors, employees, employee dependents, sub-contractors, agents and/or members as vaccine recipients. "Your" should be understood accordingly.

2. You acknowledge that the Foundation, as the lead private sector representative of the consortium of private sector buyers ("Buying Group") was designated as an Emergency Response Stakeholder last 28 February 2021  by virtue of the NTF-IATF Memorandum Circular 03-2021 and as such, it is tasked to  engage a DOH accredited healthcare service and vaccination service providers with personnel who have been trained to  administer the vaccine in accordance with the latest vaccine information ("Service Providers").

3. You confirm that You are requesting to be accommodated by the Foundation in its Inoculation Sites under these Terms and Conditions so that You can inoculate Your Vaccine Recipients as defined below.

4. You are required to use eZRx and eZVax applications, or such other applications as the Foundation may require in the future, for ordering, batch tracking and inventory monitoring as well as registration, assessment, prioritization, 2nd dose monitoring and reporting of adverse event respectively (collectively referred to as "Platform"). This Platform will enable You to make an appointment for the use of the Inoculation Sites for vaccine administration of Your employees, their dependents and other individuals whose name You have uploaded onto the Platform ("Vaccine Recipients").

5. By Your consent, given as indicated at the end of this Agreement, You confirm that You:
   1. are the authorized representative of the entity or individuals You represent with full authority to accept these Terms and Conditions, as well as to deliver and perform the obligations hereunder and You shall provide the necessary supporting board resolution or authorization, when required by the Foundation;

1. 2. have obtained the necessary consents of the Vaccine Recipients for the vaccine to be administered to them at the Inoculation Site and will provide these consents in hardcopies or electronic forms as will be required by the Foundation ("Consents");

1. 3. have executed and obtained waivers of liability and undertaking for assumption of costs, losses and damages in relation to the vaccine administration and use of the Inoculation Sites from Your Vaccine Recipients in a form to be provided by the Foundation ("Waivers");
   4. have ensured that the consent and waiver required under (b) and (c) above were executed by Your Vaccine Recipients in the form provided by the Foundation and attached hereto as Annex B and have kept the same in the event the Foundation requires submission of these documents;
   5. agree to abide by all the laws, rules and regulations on data privacy and You have obtained the consent for processing the personal information and sensitive personal information of Your data subjects, including without limitation the Vaccine Recipients;
   6. have provided truthful and correct information for purposes of prioritization of the Vaccine Recipients;
   7. are aware of the possible side effects of the vaccine as well as the possible adverse events after the inoculation and You assume all the risks in relation to vaccine administration to the Vaccine Recipients and agree to the release and waiver of any and all liabilities set out below.
   8. shall keep and maintain relevant records in respect of the Vaccine Recipients together with hardcopies of executed waivers of liability and undertaking for assumption of costs, losses and damages for a period of 10 years in the event of a government and/or vaccine manufacturer audit.

B.        THE VACCINATION PROGRAM

1. The Foundation may seek the assistance of and/or designate an ICTSI entity, which is also a member of the Buying Group, to engage Service Providers based on agreed scope of work ("Service Agreement") and procure the necessary medical equipment, other consumable medical items and such other requirements for vaccine administration. You shall fully comply with the terms of the agreements agreed with the Service Providers for the administration of the vaccine.

2. You and Your Vaccine Recipients shall utilize the Inoculations Sites, including the Platform for scheduling and services for vaccine administration (“Vaccination Program”).

3. You shall assign an administrator who shall be responsible for the use of the Platform required by the Foundation and upload all the information as may be deemed necessary by the vaccine manufacturer and pursuant to relevant rules, regulations, and applicable laws.

4. You shall upload the list of Vaccine Recipients onto the Platform and use the Platform to schedule the date and time of the inoculation of each of the Vaccine Recipients.

5. You shall pay the Cost (as defined below) to access the time slots for scheduling appointments for administration of the vaccine.

6. A Quick Response (QR) code will be generated as proof of approved scheduled appointment for vaccination ("Appointment"), which each Vaccine Recipient will be required to present at the scheduled date and time of vaccination in order to enter the relevant Inoculation Site.

7. You shall abide by the rules, programs and processes, as may be issued by the Foundation from time to time, in connection with the Vaccination Program including the observance of the required health screening, minimum public health standards and protocols during the scheduled inoculation.

C.        OTHER TERMS

1. You will promptly provide any and all additional information and/or documents required by the Foundation for purposes of the Vaccination Program.  You shall submit any required document at ifivaxadminqueries@ictsi.com

2. You shall inform each of the Vaccine Recipient that they:
   1. are required to arrive at the relevant Inoculation Site at the scheduled date and time of their Appointment;

1. 2. will not be allowed to enter the relevant Inoculation Site prior to the scheduled time of their Appointment;  and

1. 3. are required to follow the COVID -19 safety protocols and guidelines of the relevant Inoculation Site.

3. If a Vaccine Recipient is more than 30 minutes late for their Appointment or if a Vaccine Recipient fails to attend their Appointment on the scheduled time and date of the Appointment without proper written notice at least 24 hours prior to Appointment, this shall result in forfeiture of the assigned vaccine dose and the amount paid for the Cost (as defined below). 

4. For prioritization purposes, You shall inform Vaccine Recipients who are senior citizens that they are required to present an identification card to show proof of age upon registration at the Inoculation Sites.  You shall ensure  that those Vaccine Recipients with comorbidities (i)  have indicated their medical condition in the Platform and (ii) when required, are ready to show proof of comorbidity such as a.) medical certificate/clearance issued by a licensed physician specifying the full name of the attending physician and his/her contact details b.) prescription for medicines c.) hospital records such as the discharge summary and medical abstract d.) surgical records and e.) pathology or laboratory results.  Those documents should have been issued within the last eighteen (18) months. 

5. You shall inform each of the Vaccine Recipients of the following:
   1. On the day of their Appointment, the Vaccine Recipient will be medically screened at the relevant Inoculation Center before the vaccine can be administered.

1. 2. When so required by the DOH, the vaccination shall be deferred if, after screening, the Vaccine Recipient is found to be a.) presenting with sBP> 180 and/or dBP>120 with signs and symptoms of organ damage (Hypertensive Emergency) b.) in the first trimester of her pregnancy and c.) other medical conditions which, after medical screening, render him/her unfit to receive the vaccine.

6. Nothing herein (i) shall constitute an agency, partnership or joint venture between You and the Foundation or (ii) create any other commercial relationship or contract between You and the Foundation.

7. You shall abide by and comply with all laws, rules and regulations issued by the government and its agencies and shall ensure that proper safeguards are in place to ensure the privacy and protection of personal information and sensitive personal information of Your data subjects.  The terms “data subject,” “personal information” and “sensitive personal information” shall have the definitions provided under the Data Privacy Act of 2012 and its Implementing Rules and Regulations.  Personal information and sensitive personal information of Your data subjects may be processed for vaccine registration, health monitoring, data analysis, adverse events monitoring and submission to relevant government agencies.

8. The Foundation may at any time add to or modify these Terms and Conditions and you agree to be bound by such additions or modifications.

9. Administration Cost

1. The Cost is Three Hundred Fifty Pesos (Php350.00) per dose ("Cost"), exclusive of taxes, if any.  The Cost comprises the medical equipment, Personal Protective Equipment (PPEs), other consumable medical items, and other requirements for vaccine administration, amounts due to Service Providers and all miscellaneous, incidental and general out-of-pocket expenses, incurred in connection with the storage, handling and administration of the vaccine in the Inoculation Sites.  The Cost shall be non-refundable in the event the Vaccine Recipient is more than 30 minutes late for their Appointment/fails to attend their Appointment and no prior written notice has been provided as required under Clause 3 of Section C (Other Terms).  By paying the Cost, You further confirm and ratify that you have read, and that you agree to be bound by, these Terms and Conditions, including (without limitation) the release and waiver of liability, assumption of risk, and indemnity provisions contained in these Terms and Conditions.

2. You shall be required to pay the Cost based on the total number of vaccine doses allocated to you per quarter in full and in advance.   

3. You shall receive an Invoice through the email You indicated below for the Cost payable by You with the corresponding instructions for payment as well as its payment due date.  Payment could be made directly through the bank account of the ICTSI entity designated by the Foundation.

4. Inoculation shall be on a first come, first serve principle based on confirmed payment of the Cost. Time slots for scheduling will be opened for You upon receipt of payment.

5. Collection of the Cost shall be performed by an ICTSI entity within the ICTSI Group to be engaged and designated by the Foundation.  Should there be excess funds collected after deducting all the administration expenses indicated under Clause 9a., Section C. (Other Terms) hereof, any such excess shall be utilized by the Foundation in its COVID-19 related projects and activities, including those for the local communities and other non-profit organizations the Foundation supports.  

10. Your obligations

1. The Foundation shall purchase all the necessary medical equipment and other consumable medical items needed for the administration of the vaccines.  It shall enter into an agreement with the Service Providers which shall deliver the services based on agreed Scope of Work/Services for the administration of vaccines ("Service Agreement"). The Foundation shall also pay the service fees payable to the Service Providers together with all the incidental costs of inoculation. 

2. You shall pay the Cost.

3. You shall promptly submit via the Platform to the Vaccine Information Management System – Immunization Registry (VIMS-IR) a master list of the names and profiles of each Vaccine Recipient subject to the provisions of the Data Privacy Act of 2021 and issuances of the Department of Health (DOH) and the Department of Information and Communications Technology (DICT).  You shall likewise strictly comply with the prioritization on inoculation as stated under Republic Act No. 11525 and its Implementing Rules and Regulations.

4. You confirm and guarantee that each Vaccine Recipients shall execute and sign electronically and a hardcopy the necessary consent, waiver of liability and responsibility as well as an undertaking for assumption of all costs, losses and damages in relation to any adverse reaction or Adverse Event Following Immunization (AEFI).  You further agree that copies of electronic confirmation of waiver and/or its hardcopy and undertaking shall be made available to the Foundation and the Service Provider. You shall keep the hardcopies for 10 years in case of a government and/or vaccine manufacturer audit.

5. You acknowledge and agree that the engaged ICTSI entity acts solely as facilitator when (i) purchasing all the necessary medical equipment and other consumable medical items needed for the administration of the vaccines and (ii) entering into the Service Agreement with the Service Provider.

6. You also acknowledge and agree that the Service Agreement include (i) provisions in relation to the administration of the vaccines which You and the Vaccine Recipients are required to comply with and that any failure to do so may result in a delay in the administration of the vaccine, or a refusal by the Service Provider to administer the vaccine, to the relevant Vaccine Recipient and (ii) limited rights of recourse in the event of a breach by the Service Provider and limits and exclusions of liability that will limit the amounts recoverable under the Service Agreements (if any). 

7. You likewise acknowledge and agree that neither the Foundation nor the engaged ICTSI entity shall have any liability whatsoever arising out or in connection with the (i) supply of the medical equipment and other consumable medical items needed for the administration of the vaccines or (ii) supply or administration of the vaccines.

8. You confirm that You have conducted your own technical, regulatory and legal due diligence as well as research on the vaccine and are not relying on the Foundation for any aspect on this.

D.        RECOGNITION OF RISK

You recognize that the Vaccination Program involve risks, such as but not limited to product risk, supplier/procurement risk, regulatory risk, system failure risk, fraud risk, risks involving logistics provider and use of the Inoculation Sites, risks associated with Pharmacovigilance and such other risks of loss, damage, and injury involving the procurement, importation, transportation, storage, handling, distribution, delivery, administration and/or use of the vaccine, and that there may be other risks either not known or not readily foreseeable at this time; and that, nonetheless, You  fully accept and assume all risks and all responsibility for such losses, expenses, damages and injuries which You may incur in relation to this endeavor.

E.         RELEASE, DISCLAIMER & FURTHER ASSURANCE

In consideration of the Foundation agreeing to your participation in its Vaccination Program and use of the Platform and its Inoculation Sites, You, for Yourselves and for anyone who may claim on your behalf (collectively as the Releasor), hereby absolutely, completely and forever release, clear, and discharge the Foundation, the engaged ICTSI entity, their parent companies, affiliates, subsidiaries, successors, directors, officers, employees, representatives, partners and agents (collectively as the Releasee), in their individual and/or corporate capacities, from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature and kind, known or unknown, which the Releasor has or ever had or may in the future have against the Releasee arising out of or relating to this endeavor.

Should the Releasor or any of  the Vaccine Recipients make any claim, arising out of or relating to this Vaccination Program, which includes administration or use of vaccines and/or Inoculation Sites, against any of the Releasee despite the above release and waiver of liability and assumption of risk and which You duly acknowledge you made, You agree to indemnify and hold free and harmless the Foundation on its own behalf and/or on behalf of any other Releasee from any loss, liability, damage, or cost of whatever nature which the Releasee may incur as the result of such claim. 

You agree to indemnify and hold free and harmless the Foundation on its own behalf and/or on behalf of any other Releasee from any loss, liability, damage, or cost of whatever nature which the Releasee may incur or suffer as the result of, or in connection, with (i) any breach or non-fulfilment by You of any provisions of the Service Agreements and/or (ii) any liability the Releasee incurs or suffers with respect to any claim arising out of, related to, or resulting from the administration or use of vaccines and/or Inoculation Sites under the Vaccination Program.

LAW AND JURISDICTION

These Terms and Conditions are governed by the law of the Republic of the Philippines, and any dispute or difference arising under or in connection with them shall be subject to the exclusive jurisdiction of the Courts of City of Manila, Philippines.

Annex “A”

PRIVACY STATEMENT

The processing of Personal Information and Sensitive Personal Information (collectively “Personal Information”) of Your Data Subjects shall be for the purposes stated in the below Terms and Conditions for Data Sharing.  The Personal Information may be used by and disclosed to the Foundation, its parent company and/or the engaged ICTSI entity’s officers and employees whose duties require them to use it and who are required to comply with the Foundation’s obligations under existing privacy laws in their use and handling of the Personal Information.

 

You have the right to ask for a copy of any personal information we hold about you, as well as to ask for it to be rectified if you think it is incorrect. The Foundation shall not disclose your Personal Information to a third party unless it is required or authorized to do so by law, rule, or regulation or in order to establish, exercise or defend its legal rights.

 

By agreeing to the Terms and Conditions for the use of the Inoculation Sites and Data Sharing, You are freely giving your specific and informed consent for the processing of Your Personal Information and its use, retention, and disposition in accordance with the Data Privacy Act of 2012, its Implementing Rules and Regulations and the privacy policy of the Foundation, its parent company and/or the engaged ICTSI entity.

TERMS AND CONDITIONS

For Data Sharing

1. DEFINITION OF TERMS

As used herein, the following terms shall have the below respective meaning:

1. Agreement means these terms and conditions for data sharing.

2. Data sharing means the disclosure or transfer to a third party of personal information under the custody of a personal information controller or personal information processor. In the case of the latter, such disclosure or transfer must have been upon the instructions of the personal information controller concerned.

3. Data Subjects shall mean an individual/s whose personal information is processed.

4. Party shall refer to You, the Foundation, its parent company and/or the engaged ICTSI entity and collectively, shall be referred to as Parties.

5. Personal information refers to any information whether recorded in a material form or not, from which the identity of an individual is apparent or can be reasonably and directly ascertained by the entity holding the information, or when put together with other information would directly and certainly identify an individual.

6. Personal information controller refers to a person or organization who controls the collection, holding, processing or use of personal information, including a person or organization who instructs another person or organization to collect, hold, process, use, transfer or disclose personal information on his or her behalf.

7. Personal information processor refers to any natural or juridical person qualified to act as such under the Data Privacy Act of 2012 to whom a personal information controller may outsource the processing of personal data pertaining to a data subject.

8. Processing refers to any operation or any set of operations performed upon personal information including, but not limited to, the collection, recording, organization, storage, updating or modification, retrieval, consultation, use, consolidation, blocking, erasure or destruction of data.

9. Services refer to the scope of work to be performed by the Service Providers in relation to vaccine administration and/or use of the Inoculation Sites.

2. DATA PRIVACY

As a Personal Information Controller, You confirm that You have access to the Personal Information of Your employees and their dependents, consultants and other individuals who shall comprise the master list of your vaccine recipients.  

By agreeing to the Terms and Conditions for the use of Inoculation Sites, the parties acknowledge and agree that Personal Information from Data Subjects may be exchanged and shared by You to the Foundation, its parent company and/or the engaged ICTSI entity and the Service Provider and vice versa and hence may be processed for purposes relevant to the provision of services.  

The Parties have agreed to establish adequate safeguards for data privacy and security of the Personal Information of the Data Subjects and to uphold the rights of the Data Subjects in conformity with the requirements of Republic Act No. 10173 or the Data Privacy Act of 2012, its Implementing Rules and Regulations (IRR) and other issuances of the National Privacy Commission (NPC) related thereto. 

3. PURPOSES OF DATA SHARING

The sharing, use and processing of Personal Information between the Parties shall be in connection with the provisions of services to the Data Subjects and in compliance with government requirements on vaccine administration.  The use and processing of such Personal Information shall only be conducted for the following purposes:

1. Providing information on the Services to the Data Subjects;

2. To enable the Service Providers to give the necessary vaccine administration services from registration, actual inoculation and post vaccination processes;

3. To provide updates on the vaccination status of Your vaccine recipients and ensure effective vaccine administration;

4. To inform relevant government agencies on the updates of the vaccination program as may be required by relevant laws, rules and regulations.  

4. SCOPE OF SHARED PERSONAL INFORMATION

In furtherance of the abovementioned purposes, the following Personal Information of the Data Subjects may be shared and disclosed by a Party to the other:

(a)   Full name;

(b)   Gender;

(c)   Date of birth;

(d)   Email Address;

(d)   Contact Numbers;

(f)    Current Address;

(g)   Affiliated company;

(h)   Civil Status;

(i)    Occupation;

(j)    Philhealth ID;

(k)   Allergy information;

(l)    Co-morbidity information;

(m)  Vaccination status;

(n)   Adverse Event Following Immunization (AEFI) Reported;

(g)   Other Clinical Information and Medical History

5. CONSENT

As the Personal Information Controller, You confirm that you have obtained the necessary and required consent of Your Data Subjects to the data sharing between the Parties. 

6.  TRANSFER AND SHARING OF PERSONAL INFORMATION

The Parties adopt the general data privacy and data sharing principles declared in the Data Privacy Act of 2012 and its IRR, and adhere to the principles of transparency, legitimate purpose, and proportionality in the processing of Personal Information.

The Personal Information of the Data Subjects may be provided by one Party to the other Party electronically and/or through delivery of hard copies of all or some of the Personal Information by one Party to the other.  Each Party shall process Personal Information of Data Subjects disclosed or transferred to it pursuant to this Agreement and shall exercise the same degree of protection it uses with its own Personal Information.  

7. SAFEGUARDS FOR DATA PRIVACY AND SECURITY

The Parties shall implement a reasonable and appropriate organizational, physical, and technical security measures for the protection of Personal Information that are subject to data sharing. They shall take steps to ensure that any person acting under their authority and who has access to Personal Information does not process them except only insofar as to give effect to the purposes of data sharing or as otherwise required by law.

The parties shall implement security measures in accordance with industry standards that shall aim to maintain the availability, integrity, and confidentiality of Personal Information and are intended for the protection of Personal Information against any accidental or unlawful destruction, alteration, disclosure and any other unlawful processing.

The foregoing obligations and undertakings of the Parties shall continue for as long as a Party processes, uses or stores Personal Information of Data Subjects shared and disclosed by the other Party.

8. DATA BREACH

The Parties shall regularly monitor its compliance to the security measures and safeguards for the protection of the shared Personal Information.  In the event of breach in its data security affecting Personal Information of the Data Subjects, it shall notify the Data Protection Officer (DPO) of the other Party in writing, immediately and no later than twenty four (24) hours after discovery of such data breach or upon reasonable belief that such data breach has occurred.  The following information must be included in any Data Breach notification:

1. Nature of the Breach which shall include a chronology of events and an estimate of the number of data subjects affected;

2. Personal Information and Sensitive Personal Information involved;

3. Remedial measures taken or proposed to be taken to:

1. address the breach;

2. to secure or recover the personal data that were compromised;

3. to mitigate possible harm or negative consequences, and limit the damage or distress to those affected by the incident;

4. to inform the Data Subjects affected by the incident, or reasons for any delay in the notification; and

5. to prevent a recurrence of the incident.

4. Name and contact details of the Data Protection Officer or contact person designated by the Personal Information Controller to provide additional information.

1. RETENTION PERIOD

Unless applicable laws or regulations allow or require a longer period for retention, the Personal Information subject of this Agreement shall be kept and retained by the Parties for so long as may be necessary for the implementation or delivery of the relevant Services or for a period of ten (10) years, whichever comes later. 

10. REPRESENTATIONS AND WARRANTIES

Each Party represents and warrants that:

1. It is authorized to enter this Agreement and is not under any limitation, restriction or obligation that could materially and adversely affect the performance of its obligations under this Agreement.
2. The shared Personal Information of its Data Subjects that it has shared or will share are complete, accurate and correct to the best of its knowledge.
3. It has obtained and will obtain the necessary consent from its Data Subjects processing and sharing of their Personal Information in conformity with this Agreement and the Terms and Conditions for the use of the Inoculation Sites. 

11. OTHER OBLIGATIONS OF THE PARTIES

Each Party shall:

1. comply with all applicable data privacy laws and regulations in the Philippines, including the Data Privacy Act of 2012, IRR and other relevant issuances of the NPC and shall make available to the other Party, when requested in writing, all information necessary to demonstrate compliance thereto;

2. ensure that access to shared Personal Information of Data Subjects is limited only to its personnel, employees, agents, or representatives who need access for the fulfillment of the purposes stated under Clause C;

3. to uphold and respect the rights of the Data Subjects under existing laws, rules and regulations;

4. to provide the name, contact details and email address of its Data Protection Officer (DPO) for purposes of sending notices, reports and other communications required or permitted to be given under this Data Sharing Agreement.  The details of the ICTSI Group DPO is as follows:

Data Protection Officer

+63 917 7748229

dpo@ictsi.com

 

Annex “B”

Assumption of Risk and

Release and Waiver of Liability Agreement

 

I purchased the Moderna COVID-19 Vaccine (the “Vaccine”) through a Tripartite Supply Agreement to prevent Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 and have chosen the Solaire-IFI Vaccine Center Solaire Resort / Solare-IFI Vaccine Center Nayong Pilipino, Parañaque (the “Inoculation Site”).

By signing/agreeing as below, I attest that:

ASSUMPTION OF RISKS

• I am giving my full consent to be inoculated with the Vaccine at the Inoculation Site of my own will;

• I understand the risks and benefits of the Vaccine, including possible side effects and adverse reactions or events; and

• It is my sole responsibility to make an informed decision on the inoculation of the Vaccine and to have sought any needed medical advice regarding the same.

RELEASE AND WAIVER OF LIABILITY

• I hereby forever release and waive my right to bring any claim or action against ICTSI Foundation, Inc. and/or International Container Terminal Services, Inc., including their respective related companies, affiliates, subsidiaries, successors, directors, officers, employees, representatives, partners and agents, as well as all the concerned service providers (the “Releasee”), in relation to the inoculation or administration of the Vaccine and the use of the Inoculation Site.

• I understand that this waiver means I relinquish my right to bring any claims including for personal injuries, death, disease, property losses, or any other loss including, but not limited to medical expenses, hospital costs and other damages whether known or unknown, foreseen or unforeseen to the fullest extent allowed by law.

 

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE.

 

Instructions for use of Inoculation Sites:

Fill in the form below if You want to use the Inoculation Sites. Kindly note that your Invoice with payment instruction will be sent through the email address indicated below.