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Apply to join the COVID-19 Vaccine Administration Program in General Practice

The ability to apply to join the roll-out (with the AstraZeneca vaccine) is now open ongoing.

Practices need to meet the current eligibility:

  • Meet the site requirements.
  • Be either accredited, undergoing accreditation, or participating in the National Immunisation Program (NIP).

To apply:

  1. Read the COVID-19 Vaccination Site Requirements for COVID-19 Vaccination Clinics.
  2. Fill in the form below.

There is no closing date for applications.

    Practice name (name to be published/used for all external viewing)

    Contact name (key contact for all correspondence)

    Contact email address (key email address to receive communications and register with the program)

    Contact phone number (note: this is for internal use only and will not be published)

    Street name and number (address details – should align with physical address for vaccine delivery)

    City (address details – should align with physical address for vaccine delivery)

    State (address details – should align with physical address for vaccine delivery)

    Postcode (address details – should align with physical address for vaccine delivery)

    Opening hours (opening hours of your practice should be entered in XX:XXam to X:XXpm format)

    Do you hold a current accreditation through the NGPA scheme?
    YesNoUnderway

    Unique identifiers (PIP ID or AIR Provider Numbers) – If you ARE accredited, please enter your Practice Incentive Program ID number ONLY. If you are NOT accredited, please enter all AIR provider numbers that would be used to register vaccine administration. Please separate each unique identifier with a comma.

    Do you currently administer NIP vaccines, and meet the requirements for NIP in your jurisdiction?
    YesNo

    Do you meet the site requirements?
    YesNo

    Which online booking system do you use? (E.g. HealthEngine, Hotdoc, or n/a.)

    Please enter your booking system URL.