'Blue card' adverse reaction reporting form
Use this form to report suspected adverse reactions to vaccines and prescription, over-the-counter and complementary medicines.
This form can be filled in and saved to your computer using Adobe Reader version 7 or later or any version of Adobe Acrobat Standard or Professional. If you have an earlier version of Adobe Reader you can fill in the form on-screen and print it out but you will not be able to save the completed form.
'Blue card' prepaid reporting form (pdf,291kb)
Send completed Blue cards to the TGA:
- By mail to: Office of Product Review, Reply Paid 100, Woden ACT 2606
- By fax to: 02 6232 8392
- By email to: adr.reports@tga.gov.au
Content last updated: Monday, 29 October 2012
Content last reviewed: Monday, 29 October 2012
Web page last updated: Friday, 23 November 2012
URL: http://www.tga.gov.au/safety/problem-medicines-forms-bluecard.htm