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 their first dose of the COVID-19 vaccination by the dates outlined below.

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

  • First COVID-19 vaccine dose: By 30 September 2021
  • Second COVID-19 vaccine dose: By 30 November 2021

More information regarding the NSW Order from NSW Health.

First COVID-19 vaccine dose: Friday, 15th October 2021 or have a COVID-19 first dose appointment booked before 29th October 2021 
Second COVID-19 vaccine dose: Monday, 1 December 2021

What we require from you before Friday, 15th October 2021:

  • If you are unvaccinated after 15th October 2021 but have a first dose COVID-19 vaccine booking date before 29th October 2021, you must submit your first dose booking date evidence with us below. Additionally, you will be required to wear PPE including at minimum a surgical mask and face shield. If any of these requirements are not met, you will not be able to enter our premises to work. You are also required to submit your first and second dose COVID-19 vaccination evidence once it becomes available.

 

  • If you are partially vaccinated (have had one dose of a COVID-19 vaccine with a second dose booking date), you are required to submit your first dose vaccination evidence and evidence of booking to receive the second dose of a COVID19 vaccine by the second dose deadline (1 December 2021), that will cause you to become fully vaccinated. You are required to submit evidence of your second dose when it becomes available.

 

Please note: On, or after Friday, 15th October 2021 a Supplier/Contractor/Tenant who has not provided St John of God Health Care with their COVID-19 vaccination and booking information will be treated as unvaccinated and will not be able to enter, or remain on, the premises of our facilities.

Tier 1

Tier 1 health facilities include intensive care units, high dependency units, respiratory wards, emergency departments, COVID-19 vaccination clinics.

Health care workers

  • First COVID-19 vaccine dose: 1 October 2021
  • Second COVID-19 vaccine dose: 1 November 2021

Health support workers

  • First COVID-19 vaccine dose: 1 October 2021
  • Second COVID-19 vaccine dose: 1 November 2021

Tier 2

Tier 2 health facilities include all hospitals, both private and public. This includes day hospitals and nursing posts.

Health care workers

  • First COVID-19 vaccine dose: 1 November 2021
  • Second COVID-19 vaccine dose: 1 December 2021

Health support workers

  • First COVID-19 vaccine dose: 1 November 2021
  • Second COVID-19 vaccine dose: 1 December 2021

Additional information

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 if:

  • you have only received one COVID-19 vaccine dose so far, please complete and provide this evidence. Submit a second form with your second COVID-19 vaccine dose evidence when available.
  • you have already received both COVID-19 vaccine 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.