'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.
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: firstname.lastname@example.org
Content last updated: Tuesday, 11 March 2014
Content last reviewed: Tuesday, 11 March 2014
Web page last updated: Tuesday, 11 March 2014