Australian Government Pfizer Vaccine Acceptance Form

Overview

This ‘Pfizer Vaccine Acceptance Form’ has been developed for Health’s Pfizer Hubs and any other locations which receive deliveries of Pfizer Vaccines to complete when taking delivery of the Pfizer Vaccine (Product) to ensure key obligations are managed, the Product is accepted as expected and Health is notified of acceptance of the Product or any issues with the vaccine delivery instead of that arise.

This Pfizer Vaccine Acceptance Form must be completed upon arrival of the Product by no later than 9pm (local time) on the day of delivery.  However, if there is any issue with the Product delivered, Health must be notified immediately (and in any event, within 2 hours of the delivery) by calling the Vaccine Operations Centre (VOC) on 1800 318 208 and then by completing this Pfizer Vaccine Acceptance Form as soon as possible following that call. If you non-urgen queries, please email the VOC on  COVID19VaccineOperationsCentre@health.gov.au

For each Product delivery, the Pfizer Hub must complete the following sections of the Pfizer Vaccine Acceptance Form:

• Details of Pfizer Hub receiving the Product; 
• Details of Products received; 
• either Part A or Part B (depending on where the Product is delivered from); and
• Storage and Handling Requirement; and 
• Declaration.

If you are a Workforce Provider, please select 'Yes' to the 'Are you a workforce provider' question, which will then take you to relevant pages for completion.