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General Practitioner Form

Immunisation History (IM013)

A downloadable General Practitioner form for healthcare professionals.
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Specialty

General Practitioner

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Type

Form

Last edited

7/24/2026

Created by

Heidi Team

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About this form

Streamline immunisation record updates with Heidi by automatically completing the Australian Immunisation Register (AIR) Immunisation History (IM013) form. Designed for recognised vaccination providers, this form is used to record vaccinations that are not already captured on the Australian Immunisation Register when they were administered by another provider. It captures patient identification, immunisation history, vaccine names, batch numbers, administration dates, routes of administration, vaccine types, overseas vaccinations, pregnancy status where applicable, planned catch-up schedules, and provider declarations confirming the accuracy of the submitted information. The form supports reporting of National Immunisation Program (NIP), COVID-19, influenza, Japanese encephalitis, and other eligible vaccines to maintain complete and accurate immunisation records. Heidi helps clinicians efficiently generate structured documentation, reducing administrative workload, continuity of care, and compliance with AIR reporting requirements.

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