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Pharmacy: Cooloola Pharmacy

Address: 7 Dolphin Av
TIN CAN BAY, QLD, 4580

Phone: 07 5486 4304

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Boostrix

Duration: 15 min

Boostrix

COVID-19 Vaccine - Moderna

Protect your community against COVID-19 and help patients attend their booster shot booking.

Duration: 15 min

Moderna COVID-19 Vaccine (original vaccine and bivalent vaccine bookings)

Important information for COVID-19 boosters and additional doses after 6 months

ATAGI provides guidelines for booster information:
View the latest ATAGI guidelines for recommended COVID-19 vaccine doses.
For clarification on these guidelines, talk to your healthcare professional.

COVID-19 Vaccine - Moderna

Flu 65

Normal flu vaccine

Duration: 15 min

Flu 65

Flu 65+

FLUAD QUAD

Duration: 15 min

Flu 65+

Other Vaccine

Duration: 30 min

Other Vaccine

Priorix

Vaccine

Duration: 15 min

Priorix

Shingrix

Vaccine

Duration: 15 min

Shingrix

Pre-Screening Form

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Enter Your Details:

First Name*

Last Name*

Mobile*

Email*

Gender*

Are you eligible? Use the online tool to check COVID-19 vaccine eligibility.

Dose

Medicare Number

IRN

Medicare Expiry

Name on card

Enter your Medicare number and other details to reduce your waiting time in the pharmacy.

Date of birth*

Street*

Suburb*

State*

Postcode*

Reason for consultation*

What are you experiencing with your health? Provide information to help with the consultation.

Relevant background information*

Include information relevant to your situation e.g. medication you are on, recent health issues, allergies etc.

I am consenting as a substitute decision-maker (e.g. carer) on behalf of the patient

Name of substitute decision-maker*

Consent to pilot clinical service and costs*

I agree to participate in the pilot and understand the scope of the clinical service. I consent to paying the pilot consultation fee and any costs associated with the service. I understand that if I decide not to proceed with receiving some part of a service, I may still be required to pay for services that have already been provided.

Consent to pilot evaluation*

I consent to participating in the evaluation of the pilot and agree to being contacted to participate in surveys about the pilot. I consent to my administrative health service data being analysed for evaluation purposes.

Organisation Code*

Division*

Employee Status*

Participant ID*

Service selection*

I have read and accept the Guild Corporate Health Privacy Policy. I give consent for the pharmacy to provide my personal information to my employer for reconciliation and program management purposes. *

I have read and accept the MedAdvisor Terms and Conditions and Privacy Policy. *

This program closes at 4pm AEST July 31st. Do not book a vaccination after this date/time.

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