Rabies: pre-exposure request form

Request form for non-travel pre-exposure rabies vaccine.


Pre-exposure rabies request form

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Please use this form in conjunction with the guidelines for requesting rabies pre-exposure prophylaxis

Return completed request form by secure email to

Published 10 August 2017
Last updated 21 June 2018 + show all updates
  1. Updated form to accompany updated guidelines.
  2. First published.