Your COVID-19 Vaccine Status

Home Your COVID-19 Vaccine Status

How to find your vaccine record :
https://www.health.nsw.gov.au/Infectious/covid-19/vaccine/Documents/vaccination-record.pdf

*Name

*Email

*Phone Number

*Your COVID-19 Vaccine Status

I will upload my COVID-19 record on this form

I am booked in to receive my first dose before August 30, 2021

I am booked in to receive my first dose after August 30, 2021

I would like to be contacted about vaccine clinics near me

I have a medical exemption and have/will obtain a medical contraindication certificate from a medical practitioner

I do not intend to receive any COVID-19 vaccination

I prefer not to say

SignatureI consent to 8848 Disability Services collecting information regarding my vaccination status for the purpose of complying with relevant public health orders and / or for purposes related to my employment with 8848 Disability Services