Australian Childhood Immunisation Register immunisation history form (IM013)

Use this form only if a patient's immunisation history in the ACIR is not complete and another vaccination provider performed the service.

Page last updated: 29 September 2016

This information was printed Thursday 29 September 2016 from humanservices.gov.au/health-professionals/forms/im013 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.