Requesting questionnaire by mail

 About mail application of pre-examination slip

For those who receive routine vaccinations between the ages of 0 and 7 and a half and wish to have a pre-examination slip mailed, please write “(1) Type of vaccination you wish to mail and the required number of vaccinations (2) Contact phone number. Please send it to the Infectious Disease Control Division together with the reply envelope. (If you are applying for a Japanese encephalitis pre-examination slip, please write down in a memo which of the “under 3 years old”, “3 years old and over”, “second stage”, and “measures” you need.)

 (Destination) 1-3-9 Saiwaicho, Mihama-ku, Chiba 261-8755 Chiba City Health Center Infectious Disease Control Division Vaccination Group

         * Please write “Request for mailing of pre-examination slip” on the surface of the envelope.

The format of the pre-examination slip has been revised as appropriate, so please apply for the pre-examination slip by mail only for inoculation within the next 3 months .

For the reply envelope to be enclosed, use an envelope with a size of long size 3 (120 mm x 235 mm) or long size 3 or less, and enter the address and name of the recipient in the address field. , Please attach stamps (up to 4 pre-examination slips for 84 yen, 5-9 stamps for 94 yen).

Envelopes will be mailed to your home about 10 days after they arrive at the Infectious Disease Control Division (excluding weekends and holidays and holidays during the year-end and New Year holidays).

If you are in a hurry, please use the pre-examination slips provided by the city vaccination cooperation medical institution, each ward health and welfare center health section, and infectious disease control section.