COVID-19 Vaccination record query

COVID-19
Vaccination record query

Emergency

Information

Please enter your details carefully. Questions marked with a red asterisk (*) must be completed.

First Name: *

Last Name: *

Phone Number: *

Email: *

Confirm Email Address: *

Date of Birth: *

Do you have a Medicare Number? : *

Yes No

Medicare Card Number *

Individual Reference Number *

Medicare Card Expiry Date: *

Please enter your Individual Healthcare Identifier number(IHI) : *

If you do not have an IHI from Services Australia,
please visit Services Australia website

Please select which dose is
missing in AIR: *

First Dose
Second Dose
Booster 1 (First Booster) or Third Dose (Immunocompromised)
Booster 2 (Second/Winter Booster) or Booster 1 (Immunocompromised)
Immunocompromised Booster 2 / Winter Booster

Missing Record - First Dose

Where did you receive your First dose? *

What date did you get your First COVID-19 vaccination dose? *

Missing Record - Second Dose

Where did you receive your Second dose? *

What date did you get your Second COVID-19 vaccination dose? *

Missing Record - Booster 1 (First Booster) or Third Dose (Immunocompromised)

Where did you receive this COVID-19 Booster/Dose? *

What date did you get your COVID-19 Booster/Dose? *

Missing Record - Booster 2 (Second/Winter Booster) or Booster 1 (Immunocompromised)

Where did you receive this COVID-19 Booster? *

What date did you get this COVID-19 Booster? *

Missing Record - Immunocompromised Booster 2 / Winter Booster

Where did you receive this Booster? *

What date did you get your COVID-19 Booster? *

Do you require the record for
travel, work, or medical reasons? : *

Yes No

Additional Information/comments:

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