Introduction, please read closely.

General Practices that are delivering COVID-19 vaccinations in the SEMPHN region can request COVID vaccination Appointment cards and Proof of Vaccination fliers using this survey.
The stock is supplied by the Commonwealth and is limited.

South Eastern Melbourne PHN will allocate according to the number of vaccines your practice is currently allocated.

South Eastern Melbourne PHN can only supply to practices within our catchment. If needed please check the PHN Locator online.

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* 1. General Practice name

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* 2. Address Street and number. Line 1 (max 30 characters)

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* 3. Address Street and number. line 2 (max 30 characters)

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* 4. Address Suburb

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* 5. Address Postcode

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* 7. Requesting Name

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* 8. Phone number

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* 9. Email

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* 10. Position

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* 11. Please select if you want both or just the cards or fliers

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* 12. What is your current (maximum) weekly allocation of COVID-19 vaccines?

Thank you for your request. SEMPHN will seek to respond by email within 3 weekdays.
Generally delivery will occur on Mondays and Fridays.
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