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Ian testing form 1 PROD

(RTE)Form submission will go to ian.dong@mater.org.au

Consent Acknowledgement

By completing this form, you agree to have read and understood:
● The purpose, contra-indications and possible side-effects of this vaccination.
● It is my decision to be immunised with the Afluria Quad/Fluri Quadri or Fluad Quad vaccine.
● The vaccine is administered according to recommendations of the National Health and Medical Research Council.
● That I must remain in the vicinity for 15 minutes after the vaccination.
● My records will be uploaded to the Australian Immunisation Register for future access.
● I will not proceed with vaccination if I have had a fever or felt unwell in the previous 24 hours of my planned vaccination.
● I have read the specific points about vaccine and frequently asked questions (FAQs)


*This is a mandatory Multiple Choice checkbox

K13 PROD - Other forms (TESTING only!)