Blue card adverse reaction reporting form
- Other ways of reporting a medicine adverse event
- Report problems with agricultural chemicals or veterinary medicines to the Australian Pesticides & Veterinary Medicines Authority (APVMA)
Use this form to report suspected adverse reactions to vaccines and prescription, over-the-counter and complementary medicines.
Send completed Blue cards to the TGA:
- By mail to: Pharmacovigilance and Special Access Branch, Reply Paid 100, Woden ACT 2606
- By fax to: 02 6232 8392
- By email to: firstname.lastname@example.org
'Blue card' form
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.