Vaccine Appointment
Online Booking Form

Plan ahead and secure your preferred appointment slot with ease.
This form is intended solely for booking a vaccination appointment.
By booking in advance, you can secure your vaccine.

VACCINE & TIME SLOT SELECTION*

Vaccine Type: *

Chicken Pox

Dengue

Hepatitis A - Adult (19 years and above)

Hepatitis B - Adult (20 years and above)

Human Papilloma Virus

Influenza

Japanese Encephalitis

Measles, Mumps, Rubella

Meningococcal

Pneumococcal - PCV13

Pneumococcal - PCV15

Pneumococcal - PPSV23

Shingles

Tetanus

Tetanus, Diphtheria, Whooping Cough

Appointment Date: *

Booking Details*

Patient Type

First Visit to HLWE

Existing Patient

Booking For

Self

On-Behalf

Payment Method

Self-Pay

Insurance

Corporate

Entering your Registration Number (MRNo) will allow for faster and more accurate patient record retrieval

Registration Number (MRNo)

Patient Name* Name on NRIC / Passport NRIC/Passport No * Eg. NRIC: 700101035120 (without dashes) Email * Handphone No * Eg. 125371223

Booking By Details

Name * Email * Handphone No *

By submitting my booking, I have read and agreed to Hospital Lam Wah Ee's Terms of Use and Privacy Policy: PDPA (English) | PDPA (Bahasa Melayu).

Available Time Slots

If you are unable to make an appointment for the day due to slots unavailability, please call the clinic directly to confirm.

Medical Emergency:

Please note this form is for regular appointments. For medical emergency, please call our 24-Hour Emergency Hotline at +6046528946 .

Disclaimer:

Appointment slots are given in order to reduce your wait time as much as possible, however there may be occurrences of delay due to emergencies or unforeseen circumstances. We seek your kind understanding as we strive to provide a good service to our valued customers. .

Registration No (MRNo)

Registration Number (MRNo): 123456

Confirm Booking

Verify OTP

Please enter the 6-digit Whatsapp/SMS One-Time-Pin (OTP) sent to the mobile number ending with:

Vaccine Appointment Online Booking Form

VACCINE & TIME SLOT SELECTION*

Booking Details*

Vaccine Appointment
Online Booking Form