Health Protection Services
                    Immunisation Resources Order Form
         The Health Protection Service offers a variety of resources for clinic and waiting rooms. Resources are
         also available for patients. All efforts will be made to fulfil your order as soon as possible subject to
                                  availability.
        Contact Details:
        Office Use Only:
        Date received:
        Date order is sent:
        Back order sent:
        Order completed:
            Yes         No
        Company name:
        Company address:
        Contact Name:
        Contact Phone:
        Please fill out quantity, contact details and delivery address and return to ACT Health immunisation by
                      email: immunisation@act.gov.au or Fax: 5124 9307.
                          Description (click on link to view image)
                                  Quantity
                                  Back Order
        ACT Health Immunisation Schedule
         A4 poster (single)
        ACT Health Immunisation Schedule - Vaccine Tick Sheet 
        A4 poster (single)
        Immunisation Schedule for Adults and Adolescents - General Practitioners 
        Magnet (single)
        Immunisation Schedule for Adults and Adolescents – General Public
        Magnet (single)
                    © Australian Capital Territory, Canberra | health.act.gov.au | Enquiries: 132281
       Health Protection Services
       ACT Influenza Schedule 2019
       A4 Poster (single)
       Pre-vaccination screening checklist
       A4 Poster (single)
       Pre-vaccination screening checklist
       tear pad (50 sheets)
       Vaccination Record Card for Adolescents and Adults
       A4 Poster (single)
       Vaccination Record Card
       A5 blue book insert (single)
       Immunisation – What commonly can happen after vaccination and what to do
       tear pad (50 sheets)
       Vaccines - Infants and young children requiring additional vaccines
       A4 Poster (single)
       Vaccines - Infants and young children requiring additional vaccines 
       A5 blue book insert (single)
       Immunisation program schedule of children under 5 years
       Magnet (single)
                   © Australian Capital Territory, Canberra | health.act.gov.au | Enquiries: 132281
        Health Protection Services
        Immunisation- adverse event reporting form
        Form (single)
                    Immunisation Resources Order Form 
        Please fill out quantity, contact details and delivery address and return to ACT Health immunisation by
                       email: immunisation@act.gov.au or Fax: 5124 9307.
        Description (click on link to view image)
        Quantity
        Back Order
        Immunisation - ACT Immunisation Requirements for entry into school, preschool and childcare – Parent 
        Guide 2020
           Booklet (single)
        Free Influenza Vaccine for children aged six months to under five years 
        Brochure (single)
        Free Influenza Vaccine for children aged six months to under five years 
        A4 Poster (single)
        Immunisation - Aboriginal and Torres Strait Islander - Immunise our children to stay healthy - (young girl)
        Brochure (single)
        Immunisation - Aboriginal and Torres Strait Islander - Immunise our children to stay healthy - (young girl)
        A4 Poster (single)
        Immunisation - Aboriginal and Torres Strait Islander - Immunise our children to stay healthy - (baby)
        A4 Poster (single)
        Immunisation Bravery Certificate
        A5 50-page tear pad.
                    © Australian Capital Territory, Canberra | health.act.gov.au | Enquiries: 132281
       Health Protection Services
       Immunisation Poster- Taking the Right Steps– Birth to 4-Year-old immunisation schedule
       A4 Poster (single)
       Pertussis – Whooping Cough vaccination for pregnant women
       Brochure (single)
       Immunisation - Pertussis - Are You Pregnant
       A4 Poster (single)
       Immunisation -Parent Request for School Immunisation Record
       Form (single)
       Free Influenza Vaccine for Aboriginal and Torres Strait Islander
       A3 Poster (single)
       Free Influenza Vaccine for Aboriginal and Torres Strait Islander
       A4 Poster (single)
       Pregnancy and Immunisation 
       Brochure (single)
       Immunise to Stay Healthy – NIP available vaccines for people over 65 years of age
       Bookmark (single)
       Immunisation for adults 65 years and over
                   © Australian Capital Territory, Canberra | health.act.gov.au | Enquiries: 132281