Request for Immunisation History

Complete the immunisation history request form below.

Please allow 10 working days for your request to be processed.

Request Details
Address
Request for the following service:
Disclaimer
The personal information requested above is for the purpose of administrating the Public Health and Wellbeing Act 2008 and will be used solely by Council for that primary purpose or directly related purposes. The intended recipients of the information are Council officers. Council may disclose the information to law enforcement agencies, courts and other organisations authorised to collect it. Individuals have a right to seek access to their personal information and make corrections by contacting Council’s Environmental Health Unit on 9262 6197. You may view Council’s Privacy Policy or obtain a copy from any of the Council offices.
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