Contact Name:
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Contact Number:
Contact Email:
Practice Name:
Is your practice currently registered as a COVID-19 vaccination provider?
Does your practice hold a valid accreditation through the National General Practice Accreditation Scheme?
Does your practice administer vaccines as part of the National Immunisation Program?
Are you able to supply and transport COVID-19 vaccines?
Please confirm that GPs who will administer vaccines will have undertaken the mandatory training required to deliver COVID-19 vaccination services.
Please describe the geographic reach that your practice can deliver in-home vaccinations to.
By submitting this Expression of Interest, your general practice is agreeing to arrange and administer COVID-19 vaccinations in the Brisbane North region to people requiring in-home visits at dates and times to be agreed between the patient (referred by Brisbane North PHN) and your practice.
The appointed general practices agree to invoice Brisbane North PHN monthly detailing the patients’ first name, suburb, distance from practice to patient’s home (up to 50km; over 50km); date of vaccination.
Your ROI is now submitted.
Successful applicants will be notified as soon as possible.
Please contact agedcareprojects@brisbanenorthphn.org.au if you have any questions.
