Immunisation stationery order for NSW, Vic, SA, WA, Tas, ACT form (IM003)

Use this form to order immunisation stationery if you are a vaccination provider in New South Wales, Victoria, South Australia, Western Australia, Tasmania or ACT.

If you are located in the Northern Territory or Queensland you should use the Immunisation stationery order for QLD and NT form.

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.
This information was printed Saturday 25 May 2019 from It may not include all of the relevant information on this topic. Please consider any relevant site notices at when using this material.

Page last updated: 13 March 2019