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 and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology or need an interpreter.

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.

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

Page last updated: 15 May 2025.
QC 21676