Dear Students, thank you for registering in the Faculty of Health and Wellness Sciences. We are looking forward to welcome you in our faculty and various clinical sites.

Workplace-based learning (or working in industry) is one of the requirements to successfully complete any programme offered in the faculty. A requirement for safe placement in workplaces, is to be fully vaccinated against diseases you might be exposed to during your placement.

The purpose of this form is to determine your vaccination history as a requirement of workplace-based learning. Please complete this form truthfully, and provide supporting evidence to your clinical lecturer/instructor and/or worplacement coordinator.