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How to use or fill out n a h u e l - forma-color
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your Client number, Postcode, and Council in the designated fields at the top of the form.
- Fill in the Number of Vaccines required and indicate if you are a Non-EHA Client or non-Medicare by checking the appropriate box.
- For the Immunisation Consent section, print clearly using block letters. Enter the Family Name, First Name, Middle Initial, Date of Birth, and Age.
- Select your gender by checking either Male or Female. Complete your Address, Suburb, Postcode, Council area, Phone/mobile number, and Email address.
- If you do not have a Medicare Card, ensure to note that fee payment is required before vaccination.
- Review and tick off items on the Pre-Vaccination Checklist to confirm your health status.
- Provide consent by signing your name and indicating your relationship to the person being vaccinated. Ensure to date this section as well.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.9 Satisfied (59 Votes) |
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