Australian Immunisation Register (AIR) - application to register as a vaccination provider form (IM004)

Use this form to register as a vaccination provider with the Australian Immunisation Register (AIR).

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

Vaccination providers use the AIR to record vaccinations and access immunisation information of individuals.

If you have a Medicare provider number and you are eligible to administer vaccinations, you do not need to complete this form. You can use your Medicare provider number to submit data to the AIR.

Only eligible providers can register as a vaccination provider.

AIR provider numbers are not transferable. You must apply for a new AIR provider number if a business changes ownership or business structure resulting in a new ABN. Use this form to apply.

Make sure you select the right provider type when you’re registering as a vaccination provider.

If you already have a vaccination provider number, learn how to add or update your bank details.

Download and complete the Australian Immunisation Register (AIR) - application to register as a vaccination provider form.

Page last updated: 25 February 2026.
QC 21676