Covid-19 vaccination form (Personal Assistants and Agencies)

Closed 26 Apr 2021

Opened 26 Jan 2021


This form is designed for social care workers and Personal Assistants wishing to book a Covid-19 vaccination appointment. To be eligible, you must work as a paid Personal Assistant and social care workers (agency or independently employed).

The information you provide will be kept in accordance with terms of current Data Protection legislation and will only be used to determine if you are eligible for a vaccine appointment at this time. Your details will not be passed on to any other individual, organisation or group. Leicester City Council is the data controller for the information on this form for the purposes of current Data Protection legislation.


  • All Areas


  • Service providers
  • Partner agencies
  • Personal assistants


  • Public health
  • Adult social care