Life Saving Drugs Program – Paroxysmal nocturnal haemoglobinuria – Meningococcal vaccination certificate

Treating physicians use this document to certify their patient's meningococcal vaccination status when applying or reapplying for eculizumab through the Life Saving Drugs Program.

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Life Saving Drugs Program – Paroxysmal nocturnal haemoglobinuria – Meningococcal vaccination certificate

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Publication date:
Last updated:
Publication type:
Form
Audience:
Health sector
Language:
English
Description:

This form contains:

  • Information about vaccination requirements
  • Treating physician details
  • Patient information
  • Vaccination confirmation.

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