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COVID-19 vaccination – Consent form

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Publication date: 
25 May 2021
Last updated: 
12 October 2021
Publication type: 
Intended audience: 
General public

This consent form is not mandatory. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination.

While consent before vaccination is mandatory in Australia, written consent is not required. Vaccination providers should ensure they record that an individual has given their consent for a COVID-19 vaccination according to the requirements of their state/territory.

This form should be used in combination with the COVID-19 vaccination consent and FAQs, which will assist in discussions around consent and any medical contraindications or issues that may arise in your conversations with patients.

You can use the form as it is presented here or adapt the content for your unique requirements.

If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding.

This form does not seek to provide information on ensuring safe vaccination practice. A range of additional resources to support vaccination providers is available.