Australian Childhood Immunisation Register (ACIR) forms
- Application to register as an immunisation provider [PDF, 146Kb] - for immunisation providers (other than general practitioners) to register with the ACIR before sending immunisation data.
- Bank account details for immunisation providers [PDF, 135Kb] - for general practitioners to receive payment for immunisation data sent to the ACIR and other immunisation providers to update their bank account or credit union details recorded on the ACIR.
- Immunisation History form (IMMU13) - for reporting immunisation details to the ACIR when another immunisation provider performed the vaccination service.
- Immunisation encounter form [PDF, 208Kb] - for reporting immunisation details to the ACIR when you performed the vaccination service.
- Immunisation encounter header form (IMMU-1) [PDF, 149Kb] - for identifying the immunisation provider who peformed the vaccination service (used in conjunction with the Immunisation encounter form).
- Immunisation stationery order for QLD and NT (IMMU3a) [PDF, 108Kb] - for Northern Territory and Queensland immunisation providers to order immunisation stationery.
- Immunisation stationery order for NSW, VIC, SA, WA, TAS, ACT (IMMU3) [PDF, 110Kb] - for immunisation providers, excluding those in the Northern Territory and Queensland, to order immunisation stationery.
- Immunisation exemption - medical contraindication form (IMMU11) - for recording a reason why a vaccine should not be given to a child.
- Immunisation exemption conscientious objection form (IMMU12) - for recording a parent or guardian's conscientious objection to their child being immunised.
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Last updated: 1 May, 2013