AstraZeneca Vaccination Form Privacy Statement

Derbyshire Healthcare NHS Foundation Trust respects your confidentiality and understands Data Security & Protection is important to you. Data collected through the form is needed for the booking process, to support the national vaccination programme and mandatory reporting.

All information, except for the email you use to access the form, is saved securely on an internal network via encrypted transfer, which isn’t accessible via the Internet, and is only viewable at the time of data entry and at the time of vaccination to the authorised person(s) administrating the vaccine. The email address is stored externally to allow us to identify you. However, it is encrypted and located on a secure database.

The email address required to complete this form is provided to us by your relevant organisation. If you cannot access this form, as per the instructions on the page, you will need to contact the appropriate department in your organisation that deals with the approved staff vaccination list.

During the booking process, if the staff member is NOT eligible to book an appointment, the form data will be stored with the administration team, who will review the data and contact the person in question to determine vaccine eligibility.

The Trust is legally obliged to report data collected from the system to NHS England.


In this instance, the Trust will be processing data using the following legal basis:

  • GDPR Article 6(1)(e) – the processing is necessary for the performance of its official tasks carried out in the public interest in providing and managing a health service
  • GDPR Article 9(2)(i) – the processing is necessary for reasons of public interest in the area of public health

For more information and for your rights under these Articles, please see the Trust’s privacy policy or contact dhcft.dpo@nhs.net

Show accessibility tools

Original text