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Consumer vaccination pre screening consent recording form 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal information, including your name, address, phone number, and date of birth in the designated fields.
- Indicate any allergies you may have and provide the name and contact details of your general practitioner.
- Answer the mandatory question regarding Aboriginal or Torres Strait Islander origin by selecting 'Yes' or 'No'.
- For the Vaccination Needs Assessment section, tick 'Yes' for any applicable questions regarding immunity and health conditions.
- In the General Health and Suitability for Vaccination section, answer all questions truthfully to ensure safety during vaccination.
- Review the consent statement carefully. Sign and date it to confirm your agreement to receive the vaccine at the specified pharmacy.
- Complete the Pharmacy Details section with relevant information about emergency response kits and authorized immuniser signatures.
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