NSW HEALTH IMMUNISATION REGISTER TEMPLATE FOR EARLY CHILDHOOD EDUCATION AND CARE SERVICES

HOW TO USE THIS TEMPLATE

1
This electronic template has been designed to assist Early Childhood Education and Care Services to record the immunisation status of children enrolling from 1
January 2018 and managing previously enrolled children, as required under the Public Health Act 2010. Services are encouraged to use this updated template as it
includes changes relating to immunisation enrolment requirements from 1 January 2018.

2
The template is designed to be filled in electronically, but may printed blank and filled in manually. It can be printed A4 size, but it is recommended to print A3 size.
The template fits on one A4 landscape page. There are 9 rows for filling in children's details. If there are more than 9 children, please use another sheet (10 sheets are
provided). Do not add rows or columns to the template, as they will lose the automatic functions.

3 White cells may be edited. Coloured cells have automatic features which are "protected" from editing and will generate an error message.
a.
"Age at enrolment" and "Age at today's date" calculates a child's age in months when the child's birth date is entered into the "Date of birth" column.
b.
The columns titled "Evidence provided at enrolment" and "1.5 months", "4 months" … through to "48 months" contain drop down menus describing the
approved immunisation status of children at enrolment.
These options are (in order): Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)

4 Enrolment - "Age at enrolment" - select the documentation that the parent provided at enrolment from the drop down list.

5
Each time you open this template , today's date will change (yellow highlighted cell) and the child's age at today's date will be updated. Scan across the top row to
determine the age at which the next immunisation milestone is due. Eg if the child is 31 months at today's date, the next immunisation will be due at 48 months.
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Up to date - AIR Up to date - AIR Up to date - AIR 18 months Follow up when 18

Immunisation History Immunisation History Immunisation History months of age
Statement Statement Statement
2/3/2017 Sue Smith 6/25/2016 7.3 20.5

Catch up schedule - Catch up schedule - 48 months Follow up when 48

AIR Immunisation AIR Immunisation months of age
History Form History Form
12/7/2016 Dennis Aguilar 4/19/2015 19.6 34.7

Medical Exemption - Medical Exemption - Medical Exemption - Medical Exemption - 48 months Follow up when 48
AIR Immunisation AIR Immunisation AIR Immunisation AIR Immunisation months of age
History Statement History Statement History Statement History Statement
11/1/2015 Hassan El Massri 1/23/2015 9.3 37.6

Temporary exemption (valid for 12 weeks from Temporary exemption (valid for 12 weeks from
date of enrolment) date of enrolment) 12 months Follow up on 27 February
2018
(3 months after
11/27/2017 Su Wellington 12/15/2016 11.4 14.8 enrolment)

NSW Interim No need for further follow

vaccination objection up
form (ONLY if
4/15/2017 Sonya Gilmour 9/8/2016 7.2 submitted before 1 18.0
January 2018)

Example sheet
Evidence Drop-down options
Please note:
Up to date - AIR Immunisation History Statement "Age (months) at enrolment" contains a password protected formula.
Medical Exemption - AIR Immunisation History Statement "Age (months) at today's date" contains a password protected formula.
Catch up schedule - AIR Immunisation History Form "Today's date" is in the yellow highlighted cell and contains a password protected formula
Temporary exemption (valid for 12 weeks from date of enrolment) "Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018) All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited
 Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Service Name: __________________________________________ Year: 20________

ENROLMENT IMMUNISATION SCHEDULE

Age (months) at
Date of Age (months) at Evidence provided AT today's date as
Enrolment Child's name Date of Birth enrolment ENROLMENT shown below 1.5 months (6 weeks) 4 months 6 months 12 months 18 months 48 months (4 years) Next Immunisation Due Comments

Age (months) calculates

Enter age at which
Enter date of automatically when click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for click cells below for Enter any relevant
Enter name 12/12/2017 next immunisation
enrolment date of enrolment and date of drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu drop down menu comments
milestone is due
birth is entered

Evidence Drop-down options
Up to date - AIR Immunisation History Statement
Medical Exemption - AIR Immunisation History Statement
Catch up schedule - AIR Immunisation History Form
Temporary exemption (valid for 12 weeks from date of enrolment)
NSW Interim vaccination objection form (ONLY if submitted before 1 January 2018)
Early Childhood Education and Care Service
Immunisation Register - Currently Enrolled Children
Please note:
"Age (months) at enrolment" contains a password protected formula.
"Age (months) at today's date" contains a password protected formula.
"Today's date" is in the yellow highlighted cell and contains a password protected formula
"Evidence provided at enrolment" and "1.5 months - 48 months" contain drop down menus.
All other columns can be edited