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'Blue card' adverse reaction reporting form

Related information

Use this form to report suspected adverse reactions to vaccines and prescription, over-the-counter and complementary medicines.

How to access a pdf document

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' adverse reaction prepaid reporting form (pdf,443kb)

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: Tuesday, 11 March 2014

Content last reviewed: Tuesday, 11 March 2014

Web page last updated: Tuesday, 11 March 2014

URL: http://www.tga.gov.au/safety/problem-medicines-forms-bluecard.htm