Immunisation stationery order for Qld and NT form (IM006)

Use this form to order immunisation stationery if you are a vaccination provider in the Northern Territory or Queensland.

If you are located in New South Wales, Victoria, South Australia, Western Australia, Tasmania or ACT you should use the Immunisation stationery order for NSW, Vic, SA, WA, Tas, ACT form.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 13 March 2019