Register your interest in the COVID-19 Vaccine Claims Scheme

Use this form to register your interest in the proposed COVID-19 Vaccine Claims Scheme if you believe you have had a moderate to significant adverse reaction to an approved COVID-19 vaccine. You only need to register once.

Your contact details

Mobile phone number preferred.


  • I have read the department’s privacy policy.
  • I consent to the department collecting, using the personal information I have provided in this form to contact me about the COVID-19 Vaccine Claims Scheme.