Immunisation Has your child been immunised? No Yes Is it up to date? Yes No Please attach a copy of the approved documentation to the enrolment form. Refer to the Enrolment Policy. Note: An Australian Childhood Immunisation Register (ACIR) Immunisation History Statement must be supplied. Health background Has your child been diagnosed at risk of anaphylaxis? No Yes (Please list, including brief treatment summary. A Medical Action Plan which has been developed by a medical professional, and Risk Minimisation Plan will be required.) Does your child have any allergies e.g. food, medication, animal, insects? No Yes (Please list including brief treatment summary. A Medical Action plan, which has been developed by a medical professional, and Risk Minimisation Plan will be required.) Does your child have any special dietary requirements? No Yes (Please provide details.) Do you, or have you had concerns about your sight or hearing? child’s speech development, eye No Yes (Please provide details.)
Immunisation Has your child been immunised? No Yes Is it up to date? Yes No Please attach a copy of the approved documentation to the enrolment form. Refer to the Enrolment Policy. Note: An Australian Childhood Immunisation Register (ACIR) Immunisation History Statement must be supplied. Health background Has your child been diagnosed at risk of anaphylaxis? No Yes (Please list, including brief treatment summary. A Medical Action Plan which has been developed by a medical professional, and Risk Minimisation Plan will be required.) Does your child have any allergies e.g. food, medication, animal, insects? No Yes (Please list including brief treatment summary. A Medical Action plan, which has been developed by a medical professional, and Risk Minimisation Plan will be required.) Does your child have any special dietary requirements? No Yes (Please provide details.) Do you, or have you had concerns about your child’s speech development, eye sight or hearing? No Yes (Please provide details.)