Bumrungrad Moderna Booster Adolescents (Spring/Summer 2022)

Bumrungrad Moderna Booster Adolescents (Spring/Summer 2022)
Dear ISB Family Member,

ISB has purchased Moderna booster doses for ISB students aged 12 to 18 via Bumrungrad Hospital. If you are interested in having your child boosted please register below.
- This is a full dose booster per the Thai FDA and Bumrungrad Hospital.
- Six months must have passed from previous vaccination [Pfizer].
- Parents must sign a waiver and accompany students on the day of vaccination.
- It is always important to consult your child’s pediatrician for concerns regarding underlying disorders and best recommendations for your and your child.
For students who have not been vaccinated, they may also utilize this opportunity to receive their first and second dose.

ISB Health Center
Enter ISB Student Number*
Name
Grade
School
Title*
Vaccination History*
eg. 2 Doses AstraZeneka
Bumrungrad Hospital Number
If you have one
DOB*

DayMonthYear
Date
Gender*
ID Type*
Passport/Thai ID Number*
Nationality*
Phone Number*
Please enter a valid phone number.
Number of doses required*
1 for booster, 2 if not yet vaccinated
Please select dose.*
Email*
example@example.com
Address*
Any underlying disease, and describe.
Drug allergy, and describe.
Should be Empty: