About the Distribution of the COVID-19 Vaccine Passports (*For Use to Travel Abroad)

(1) The person eligible for the passport (the applicant).
(2) A proxy designated by the eligible person (see note below).
Note: If the proxy is a person not part of your household, you must complete a Power of Attorney（PDF形式：81KB） form.

(1) You must already be completely vaccinated for COVID-19.
(2) You must have had a registered address in Tokushima City at the times you received your vaccines. (*1) (*2)
(3) You must have a set plan to travel abroad.

• *1: In the case you moved out of Tokushima City after you received your COVID-19 vaccine shots, Tokushima City will still distribute your vaccine passport.
• *2: In the case you moved out of Tokushima City to another municipality in between your first and second vaccine shots, you will only receive a vaccine passport/certificate from Tokushima City for the shot received while you were a resident of Tokushima City.

Ex. 1st shot: Tokushima City resident -> move out of the city -> 2nd shot (while you are a registered resident of a different municipality)

• In this scenario, Tokushima City would only issue you a passport/certificate for the vaccine shot you received while a resident of the city. Your new municipality will issue the portion for the 2nd shot.

(1) COVID-19 Vaccine Passport application form (please fill out the required parts of the application beforehand)
(2) Applicant's passport (your country's travel passport) or a copy of the passport page that includes their photo, name, and passport number (*1) (*2)

• *1: For those who have their former surname, alternative surname and/or alternative name listed on their (travel) passport, in addition to your (travel) passport, please bring a form of ID that lists the former/alternative name.
• *2: Please be sure that the form of ID is not expired.

(3) In the case you are applying by proxy: a form of ID for the proxy
(4) In the case you are applying by proxy: Letter of Attorney
(5) Record proving completion of vaccination and showing the applicant's COVID-19 vaccination number (any one of these: your Certificate of Vaccination for COVID-19, vaccination record, or a copy of your Prevaccination Screening Questionnaire)
(6) The applicant's COVID-19 Vaccine Ticket (with the portion showing your COVID-19 vaccination number)

Please apply at the Health & Longevity Division (Counter 31) on the 2nd floor of the South Wing of the Tokushima City Hall.

• For those who are not confident in their Japanese and do not have a Japanese speaking friend (etc.) who can accompany them to the Consulation Desk, English interpretation services may be available. Please fill out the following inquiry form to request an interpreter.

✉Inquiry Form

Mon~Fri: 8:30~17:00
(Excluding national holidays on weekdays and the period of Dec. 29~Jan 3)

Free/no charge.

In addition to filled out the necessary sections of (1), please also include items (2)~(7) in the same envelope you send your application in.
(1) COVID-19 Vaccine Passport application form (application form for applying by post) (*1) (*2)

• *1: Please write a phone number that we can use to reach you during the daytime.
• *2: In the case that you have moved out of Tokushima City, please ALSO write the address where you lived at in Tokushima City in the address line. (Please write your current address and previous Tokushima City address in the same field box.)

(2) Return envelope with your address pre-written on it and the appropriate postage stamp attached
(3) A copy of the applicant's (travel) passport page that includes their photo, name, and passport number (*3) (*4)

• *3: For those who have their former surname, alternative surname and/or alternative name listed on their (travel) passport, in addition to your (travel) passport, please bring a form of ID that lists the former/alternative name.
• *4: Please be sure that form of ID is not expired.

(4) A copy of a form of ID (that shows the return address for the sender of the application form)
(5) In the case you are applying by proxy: Letter of Attorney or other document proving the applicant requested a proxy.
(6) COPY of a record proving completion of vaccination and showing the applicant's COVID-19 vaccination number (any one of these: your Certificate of Vaccination for COVID-19, vaccination record, or a copy of your Prevaccination Screening Questionnaire)
(7) The applicant's COVID-19 Vaccine Ticket (with the portion showing your COVID-19 vaccination number)

(Address to send the application to:) 〒770-8571　徳島県徳島市幸町二丁目5番地
　徳島市役所　健康長寿課　ワクチン接種証明担当　宛

• Please also write ワクチン接種証明書在中 somewhere on the application envelope. (This means "contains vaccination certificate")

It takes about 10 working days from Tokushima City receiving an application for the vaccine passport to be shipped to you.

In the case there are issues confirming your vaccination status, it may take longer than 10 working days to process your application.

(If you apply at the designed counter 31) while the vaccine passport will usually be issued to you on the same day, please understand that it may take longer to issue you the passport if there are issues checking the documents you submit.

Health & Longevity Division TEL: 088-621-5523 (cannot support foreign language)