N a h u e l - forma-color 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Client number, Postcode, and Council in the designated fields at the top of the form.
3. Fill in the Number of Vaccines required and indicate if you are a Non-EHA Client or non-Medicare by checking the appropriate box.
4. For the Immunisation Consent section, print clearly using block letters. Enter the Family Name, First Name, Middle Initial, Date of Birth, and Age.
5. Select your gender by checking either Male or Female. Complete your Address, Suburb, Postcode, Council area, Phone/mobile number, and Email address.
6. If you do not have a Medicare Card, ensure to note that fee payment is required before vaccination.
7. Review and tick off items on the Pre-Vaccination Checklist to confirm your health status.
8. 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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