Australian Immunisation Register immunisation history form (IM013)

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

AIR is the Australian Immunisation Register.

This form can be completed online. Read more about HPOS.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 3 November 2016

This information was printed Friday 9 December 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.