The University of Queensland
School of Social Work and Human Services
IMMUNISATION RECORD
All students commencing placement must ensure that this immunisation record is completed (or
alternatively, an official immunisation document that has been signed by a health professional
and clearly identifies the student) and returned to the Field Education Unit at least two weeks
prior to placement.
Name:
Student Number:
Students need to have the full three-vaccination Adult vaccination course prior to placement of:

Hepatitis B (can take up to 6 months to complete)
Alternatively, students can choose to have the accelerated Hep B vaccination schedule which
consists of:


3 vaccinations within 21 days, followed by a booster dose 12 months later or
3 vaccinations at monthly intervals followed by a booster dose 12 months later
Please note that proof of immunity to Hep B is required to qualify for a Queensland Health
placement.
This section to be completed by a medical practitioner.
Date of
Vaccination
Hepatitis B
Immunity Test
Hepatitis B
(Accelerated
Schedule)
Booster (12 mths)
Immunity Test
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Name of Practitioner
Signature of Practitioner