Use the Australian Immunisation Register (AIR) application form to register as a vaccination provider (IM004 form) if you are an individual or organisation applying to register as a vaccination provider to obtain a registration number for the purposes of recording vaccinations on the AIR and accessing immunisation information of individuals.
If you are a principal pharmacist immuniser applying for the AIR provider number on behalf of your pharmacy, please also complete and submit the NSW Pharmacist Immuniser Declaration Form .
If you are a general practitioner with a registered Medicare provider number, you do not need to complete this form. You can use your Medicare provider number to submit data to the AIR.
