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OFFICE USE ONLY Date received: ___ Year Level:.___ Birth certificate/Passport YES NO AIR immunization history statement YES NO Student resides within local intake area YES NO Proof of address YES

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How to fill out immunisation history statements for

01

Step 1: Gather all relevant immunisation records such as vaccination cards or medical documents.

02

Step 2: List down all the vaccines received in chronological order starting from birth.

03

Step 3: Include the dates of each immunisation dose received.

04

Step 4: Specify the vaccine manufacturer and lot number if available.

05

Step 5: Sign and date the immunisation history statement to certify its accuracy.

Who needs immunisation history statements for?

01

Individuals applying for school admission

02

International travelers

03

Healthcare workers

04

Immigrants or refugees

05

Individuals participating in certain activities or programs requiring immunisation

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What is immunisation history statements for?

The immunisation history statements are used to record and track an individual's immunisation records.

Who is required to file immunisation history statements for?

Parents, guardians, and healthcare providers are required to file immunisation history statements for children.

How to fill out immunisation history statements for?

Immunisation history statements can be filled out by providing details of each immunisation received, including the date and type of vaccine.

What is the purpose of immunisation history statements for?

The purpose of immunisation history statements is to ensure that individuals are up to date with their vaccinations and to prevent the spread of vaccine-preventable diseases.

What information must be reported on immunisation history statements for?

The information that must be reported on immunisation history statements includes the date of each immunisation, the type of vaccine administered, and the dosage.

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