Complete the form below to provide details of vaccination records. If your immunisation history is in another language other than English, it will need to be translated prior to submitting. Child Details Child's Surname Child's name Gender Male Female Medicare number Medicare ID number Found next to child’s name on card Date of Birth Contact Details Name of parent/guardian Present Address Present Address Suburb State - Select -Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postal Code Former Address If applicable Email Mobile Immunisation History Upload a copy of immunisation records Maximum 3 files.5 MB limit.Allowed types: pdf, doc, docx, jpeg, jpg. Choose a File Where the child was immunised Select the checkbox to confirm this is a valid submission. Leave this field blank Families Arriving From Overseas
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