Supplier / contractor / tenant vaccine declaration form

St John of God Health Care Inc (SJGHC), including its related entities, is committed to upholding the dignity of each person. Guided by the value of respect, we will manage all personal information in accordance with the Australian Privacy Principles (APPs) and the Notifiable Data Breaches scheme under the Privacy Act 1988 (Cth) (Privacy Act) and all other relevant Commonwealth and State legislation. The SJGHC Privacy Brochure outlines how SJGHC collects, obtains, holds, uses and discloses your personal information in accordance with SJGHC’s Privacy Policy. A copy of our Privacy Brochure is available and can be provided to you upon request or by visiting www.sjog.org.au/privacy.

What information is being collected and why?

Various Australian states and territories have issued public health directives in relation to mandatory vaccinations in certain sectors, including health care.

Where authorised under those directives, SJGHC is required to collect and maintain information in relation to the COVID-19 Vaccination Status of the contractors, suppliers and caregivers who attend a hospital/service. SJGHC is also permitted to collect this information under the Privacy Act to lessen or prevent a serious threat to the life, health or safety of any individual or to public health or safety.

In association with the Vaccination Status of our contractors, suppliers and caregivers, SJGHC will collect the following information:

  • name;
  • date of birth;
  • a copy of the:
    • the COVID-19 digital vaccination certificate;
    • an immunisation history statement issued by Medicare showing the COVID-19 vaccination recorded on the Australia Immunisation Register; or
    • written confirmation issued by the Department of Health stating the COVID-19 vaccination has been received by the contractor, supplier or caregiver; and
  • contact details.

How will this information be used?

SJGHC will use your personal information to:

  • check whether vaccination has occurred;
  • determine whether access to our sites is permitted in accordance with the public health directive;
  • identify whether an individual is due to receive a booster;
  • identify areas of risk or precautions required during a COVID19 outbreak; and
  • comply with any applicable laws.

SJGHC will only use and disclose your personal information in accordance with the Privacy Act and the Australian Privacy Principles.

What happens if I refuse to provide this information?

If you choose not to provide SJGHC with your personal information in regards to your COVID-19 Vaccination Status, you may be refused entry into SJGHC premises.

Who else has access to my information?

We may use the services of third party service providers for IT systems, professional advice and other functions which may be based or have operations outside of Australia and may require access to your personal information involved with the service provided. All service providers that have access to personal information held by us are required to keep the information confidential and in accordance with the Privacy Act and not to make use of it for any purpose other than to provide services in accordance with their engagement.

How can I access my information, seek corrections or make a complaint?

Our privacy policy contains information about how you may access your personal information and seek correction of such information; as well as how to complain about a breach of the Australian Privacy Principles and how we will deal with such a complaint.

Our privacy policy is accessible at www.sjog.org.au/privacy.

COVID-19 vaccination date requirements

St John of God Health Care requires that all suppliers, contractors, and tenants accessing or providing services at any of our St John of God Health Care facilities must have received the correct COVID-19 vaccinations as set out in Public Health Orders released by relevant State Governments.

These dates vary by state, and in Western Australia (WA), will be dependent on which facilities are accessed. It is important that all safety measures are adhered to. 

In addition to our double vaccination requirements, we have updated COVID-19 booster vaccination requirements for suppliers and contractors who visit St John of God Health Care facilities.

All suppliers/contractors and their employees, agents, and subcontractors visiting a St John of God Health Care facility must receive their COVID-19 booster by the dates outlined below.

From Friday 21 January 2022, booster vaccinations can be given three or more months after your first two doses of a COVID-19 vaccine.

For more information refer to the NSW Public Health Order.

  • For workers who received their second dose on or before 12 September 2021, you must receive your booster by 12 February 2022.
  • For workers who received their second dose after 12 September 2021, you must receive your booster by 29 March 2022.

 For more information regarding the VIC Order refer here.

  • For workers who were eligible to receive a booster on or before 3 January 2022 (a period of five months from the date of their second dose), you must receive your booster by 5 February 2022.
  • For workers who were eligible to receive a booster between 4 January and 30 January (a period of four months from the date of their second dose), you must receive your booster one month from the date you became eligible.
  • For workers who were eligible to receive a booster on or after 31 January (a period of three months from the date of their second dose), you must receive your booster one month from the date you became eligible.

You can check what date you are eligible for your booster (i.e. third dose) at www.rollup.wa.gov.au 

For more information regarding the WA Order and full definitions refer here.

Vaccination evidence

Following the recent Public Health Orders we request that you please submit your vaccination records to provide evidence of your vaccination.

Supplier/contractors/tenants should complete this form to submit your record of vaccination. Please submit the form for your first second or third dose. If you have already submitted a vaccine declaration and have since had an additional (second or third dose), please submit an additional form for the subsequent doses.

Step 1: Download your vaccination evidence

Instructions on how to access evidence of your vaccination records are provided by servicesaustralia.gov.au.

Accepted evidence format:

  • Immunisation History statement from Australian Immunisation Register (AIR) available from the Medicare section of your MyGov account, or the Express Plus Medicare App (can be accessed if you have had just your first dose, or both first and second) 
  • COVID-19 Digital Certificate available on the Medicare section of your MyGov account, or the Express Plus Medicare App (applicable only if you have already received both your first and second dose) 
  • Written confirmation issued by the Department of Health of the COVID-19 vaccination received
  • Calling the AIR on 1800 653 809 and request a printed copy
  • Visiting a Services Australia (Centrelink, Medicare) service centres

Step 2: Submit your vaccination evidence via the Vaccine Record Submission Form

Important Note: Visiting Medical Officers have been issued an individual login to submit vaccination records.  Please do not submit here.

If you have tested positive for COVID-19 then you can have the vaccine any time after the virus has resolved but waiting a month after you are fully recovered is the recommended timing for a third dose.

What to do if you become aware of cases within your organisation

As a contractor or supplier, if you become aware of any cases of infection within your organisation, or your subcontractors, advise us immediately by return email to [email protected] with the subject heading ‘URGENT: COVID-19 case’.

What to do if you are not able to provide proof of vaccination

If for any reason a supplier or contractor is not able to continue to provide services to St John of God Health Care under these conditions, and or meet the vaccination requirement dates, please email [email protected] using the subject heading: ‘Unable to provide services’.