Australian Immunisation Register (AIR) - immunisation medical exemption form (IM011)

Use this form if you don’t have access to the AIR or practice management software (PMS). You can use it to report an individual’s immunisation medical exemption.

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.

If you’re an eligible health professional (or their HPOS delegate), you can quickly record an immunisation medical exemption:

  • directly to the AIR using HPOS, you’ll need an individual PRODA account
  • using PMS that supports vaccination reporting.

If you need help linking your HPOS account to AIR, call the AIR Internet helpdesk. For help with PRODA, call the PRODA helpdesk.

Contact your software vendor if you’re unsure whether your software can record immunisation medical exemptions.

If you submit an immunisation medical exemption using the form upload function in HPOS Messages:

  • it must be lodged using the HPOS account of the health professional who signed the form, or on their behalf by a nominated HPOS delegate
  • it can take up to 14 days to update an individual’s AIR record
  • we may contact you to confirm the details.

Download and complete the Australian Immunisation Register (AIR) - immunisation medical exemption form.

Only eligible health professionals can use this form. You are eligible to use this form if you’re a:

  • general practitioner, as defined in the Health Insurance Act 1973
  • general practice registrar on an approved 3GA training placement
  • paediatrician
  • public health physician
  • infectious diseases physician
  • clinical immunologist.
Page last updated: 25 September 2025.
QC 21636