Flu Vaccine Consent Form
Don Medical Clinic - Dedicated Mass Flu Immunisation Clinics - have now been completed for 2020.
IMPORTANT INFO - We Now only have availability of public funded flu vaccinations (We do not have any private vaccines available). If you complete this form and it indicates you are NOT eligible for the free vaccine, DO NOT Pay or book an appointment. You can email firstname.lastname@example.org and we can put you on a wait list. We cannot gurantee supply of additional flu vaccines at this stage so we suggest you check around.
Free Vaccines are currently available for the following people
1. aged 6 months to 5 years (Once the child turns 5 they are ineligible on this criteria)
2. aged 65 and over
3. Aboriginal and Torres Strait islander: 6 months and older.
4. Eligible Chronic disease - Heart, respiratory, cancer, Neurological,
5. Pregnant women
All Don Medical Flu vaccination visits are short visits purely for the vaccine. No other medical conditions will be discussed. These Visits will be bulk billed to Medicare. Currently these are only available for patients eligible for the "free" vaccine as listed above. .(If your employer has negotiated a private arrangement with Don Medical Clinic, your vaccine and consultation fee will be paid by your employer and you just need to complete this form only)
Step 1: Pre vaccination and consent form (below)- This must be completed prior to making your appointment as this will also determine if will need to pay for your flu shot or are eligible for agovernement funded vaccine. To keep a minimal amount of human contact with pens and paper we are using this online consent form this year. (see below). This form needs to be completed for EACH person in the family having the Flu vaccine. For children and patients under care, the parent or carer will need to complete, sign and submit this form for each person. Once this is completed you will receive an email to the Appointment booking page and to the Online payments page
Step 2: Appointment Booking - Due to COVID-19, we are currently running limited face to face consultations on a needs basis. If you require a Flu immunisation and are eligible for the "free" vaccine, Please call reception on 6441 5299 to arrange an appointment for this.
any issues please contact reception on
P: 03 6441 5299