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Vaccination Declaration


This form is provided for Prompt Care staff members to report if they have received a COVID-19 or Influenza (Flu) vaccination this year (2021). 

The Australian Government has requested providers of in-home aged care services such as Prompt Care provide de-identified data on the percentage of staff who have received a COVID-19 vaccine.

Vaccination is the most effective protection against COVID-19. Protecting senior Australians in the community and those who care for them is a priority. That is why it is important for governments and aged care providers to understand how many aged care workers have been vaccinated against COVID-19. This information helps to understand risks to senior Australians and the workers who care for them, as part of preparing and planning for a COVID-19 outbreak.

If there is a COVID-19 outbreak in your community, it will be important to know how many workers have been vaccinated so that protective measures can be put in place for those who have not been vaccinated.

For further information, please visit

You may be reimbursed for your Influenza Vaccination if you have held onto the receipt.