Australian Government Oxford-AstraZeneca Vaccine Acceptance Form

Overview

IF YOU ARE A GP, GPRC OR ACCHS, DO NOT SUBMIT AZ ACCEPTANCE FORMS THROUGH CITIZEN SPACE. PLEASE COMPLETE IT THROUGH THE COVID-19 VACCINE ADMINISTRATION SYSTEM (CVAS) on cvas.health.gov.au. REPORTS SUBMITTED THROUGH CITIZEN SPACE WILL NOT BE ACCEPTED.

This ‘AZ Vaccine Acceptance Form’ has been developed for locations (Sites),  which receive deliveries of AstraZeneca vaccines (AZ Vaccines)  to complete when taking delivery of AZ Vaccine to ensure that:

• AZ Vaccines are received, stored and handled appropriately
• key obligations are managed,
• the AZ Vaccines are delivered as expected, and
• the Department of Health (Health) is notified of receipt of the AZ Vaccines or any issues that arise. 

Responsibility

This AZ Vaccine Acceptance Form must be completed at the time that you receive the AZ Vaccine at the Site and sent to Health by no later than 9pm (local time) on the day of delivery.  However, if there are any issues with the AZ Vaccines delivered, Health must be notified immediately (and in any event, within 2 hours of the delivery) by calling the Vaccine Operations Centre on 1800 318 208 and then by providing this AZ Vaccine Acceptance Form by email to COVID19VaccineOperationsCentre@health.gov.au as soon as possible following that call.

To complete this AstraZeneca Vaccine Acceptance Form, you must complete every section of this form.