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Pharmacy: Banovich Pharmacy South Fremantle

Address: 8/195 Hampton Rd
South Fremantle, WA, 6162

Phone: 08 9335 4884

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COVID-19 COMIRNATY LP.8.1

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COVID-19 COMIRNATY LP.8.1

Duration: 5 min

COVID-19 COMIRNATY LP.8.1

Flu Vaccination (Free Flu Program) 12-64 yrs

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Free Flu Vaccination (NIP) from May-June 2025

Duration: 10 min

Flu Vaccination (Free Flu Program) 12-64 yrs

Flu Vaccination 65+ yrs

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Free for patients 65 years and over

Duration: 15 min

Flu Vaccination 65+ yrs

FluMist Nasal Spray 2-11 years

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FluMist 2-11 years (Free)

Duration: 10 min

FluMist Nasal Spray 2-11 years

Respiratory Syncytial Virus (RSV) (Pregnancy)

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Free under National Immunisation Program for pregnant woman between 28-36 weeks of pregnancy

Duration: 15 min

Respiratory Syncytial Virus (RSV) (Pregnancy)

Respiratory Syncytial Virus (RSV) (Private)

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Respiratory Syncytial Virus (RSV) (Private)

Duration: 15 min

Respiratory Syncytial Virus (RSV) (Private)

Respiratory Syncytial Virus (RSV) aged 75+

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Respiratory Syncytial Virus (RSV) aged 75+

Duration: 15 min

Respiratory Syncytial Virus (RSV) aged 75+

Shingles (NIP 65+ yrs)

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Free Shingrix (Shingles) Vaccine for 65 years and over + Immunocompromised patients under National Immunisation Program (Contact pharmacy for more information/eligibility)

Duration: 15 min

Shingles (NIP 65+ yrs)

Shingrix (Private)

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Shingrix (Private)

Duration: 5 min

Shingrix (Private)

Whooping cough (dTpa) (Pregnancy)

About this service

Free under National Immunisation Program (NIP) for pregnant woman between 20 to 32 weeks of every pregnancy but it can be given up to the time of delivery

Duration: 15 min

Whooping cough (dTpa) (Pregnancy)

Whooping cough (dTpa) (Private)

About this service

Whooping cough (dTpa) (Private)

Duration: 15 min

Whooping cough (dTpa) (Private)

Pre-Screening Form

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First Name*

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Medicare Number

IRN

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Name on card

Enter your Medicare number and other details to reduce your waiting time in the pharmacy.

Date of birth*

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Reason for consultation*

What are you experiencing with your health? Provide information to help with the consultation.

Relevant background information*

Include information relevant to your situation e.g. medication you are on, recent health issues, allergies etc.

I am consenting as a substitute decision-maker (e.g. carer) on behalf of the patient

Name of substitute decision-maker*

Consent to pilot clinical service and costs*

If applicable, I agree to participate in the Queensland Community Pharmacy Chronic Conditions Management Pilot and understand the scope of the clinical service. I consent to paying the pilot consultation fee and any costs associated with the service. I understand that if I decide not to proceed with receiving some part of a service, I may still be required to pay for services that have already been provided. I understand that my pharmacist will inform me if this is applicable to my situation.

Consent to pilot evaluation*

If applicable, I consent to participating in the evaluation of the Queensland Community Pharmacy Chronic Conditions Management Pilot and agree to being contacted to participate in surveys about the pilot. I consent to my administrative health service data being analysed for evaluation purposes. I understand that my pharmacist will inform me if this is applicable to my situation.

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I have read and accept the Guild Corporate Health Privacy Policy. I give consent for the pharmacy to provide my personal information to my employer for reconciliation and program management purposes. *

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This program closes at 4pm AEST July 31st. Do not book a vaccination after this date/time.

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