Please fill out your details on the form provided and email to GSK Vaccines Department: [email protected] or post to GlaxoSmithKline, PO box 18095 Melbourne 8003 PLEASE PRINT IN BLOCK LETTERS GSK Healthcare Worker Material Request Form Title:_________ Name: _______________________________________ Role: __________________________ Organisation: _____________________________________________________________________________ Address: _________________________________________________________________________________ Phone: __________________________ Email: __________________________________________________ HCW INFLUENZA AWARENESS BROCHURE AUS/FLU6/0029/16 QTY ___________________________ INFLUENZA HEALTHCARE WORKERS GET VACCINATED AND BE FLU READY HELP GUARD AGAINST INFLUENZA Have you had your flu vaccine? GlaxoSmithKline Australia Pty Ltd ABN47 100 162 481. Melbourne Vic. AUS/FLU6/0029/16. Date of Approval: December 2016 For information on GSK products or to report an adverse event involving a GSK product, please contact GSK Medical Information on 1800 033 109. © GSK Group of Companies. All rights reserved. References: 1. Australian Technical Advisory Group on Immunisation (ATAGI). The Australian Immunisation Handbook 10th Edition (2016 Update). Canberra: Department of Health. 2. Myths and Misconceptions- Influenza and vaccination. Influenza Specialist Group Nov 2015 http:// isg.org.au/index.php/about-influenza/myths-and-misconceptions/. Accessed Oct 2016. 3. Key facts about Influenza. Centers for Disease Control and Prevention http://www.cdc.gov/flu/keyfacts.htm. Accessed Oct 2016. Influenza vaccination is the most effective way to prevent infection for you and your patients. 1 ARE YOU FLU READY? Talk to your healthcare worker program coordinator for more information on influenza vaccination. Healthcare workers have a higher chance of contracting influenza and of infecting their patients.YOU AND YOUR PATIENTS ARE AT RISK The influenza virus strains change and your immunity wanes over time.Vaccination is therefore recommended every year.ANNUALLY EVERY 12 MTHS HCW Influenza awareness brochure provides more information on commonly asked question regarding influenza vaccination HCW INFLUENZA AWARENESS POSTER AUS/FLU6/0029/16a / f QTY A3 (16a) ____________________ QTY A4 (16) _____________________ INFLUENZA Influenza is a serious infection. Symptoms tend to be more severe than the common cold, and can result in HELP GUARD AGAINST INFLUENZA Have you had your influenza vaccine? An A3 or A4 poster to help build awareness for HCW influenza vaccination HCW INFLUENZA AWARENESS POSTER AUS/FLU6/0029/16d / g QTY A3 (16d) ___________________ QTY A4 (16g) ___________________ INFLUENZA An A3 or A4 poster to encourage HCW influenza vaccination with space below to write time/date/ location of vaccination clinics All GSK Vaccines Product Information and Consumer Medicine Information are available from au.gsk.com We, GlaxoSmithKline Australia Pty Ltd ABN 47 100 162 481 collect, use and disclose personal information about you so we can perform our business activities and functions. We collect your personal information in order to administer disease awareness/management programs or other similar programs organised by us, send you material on and contact you regarding our activities and products. If we do not collect your personal information we may be unable to provide you with all of our services, for example information regarding our programs, events, services or products which may be of benefit to you. We will only disclose your personal information as necessary to third parties that we use in the ordinary operation of our business, such as for conference organising, marketing, data processing and associated printing and mailing. We will not disclose your personal information overseas. Our privacy policy can be found at http://www.au.gsk.com/en-au/privacy-policy/ and contains information about how you may access and correct personal information held by us and how you can complain about a breach of privacy and how we will deal with such a complaint. For information on GSK products or to report an adverse event involving a GSK product, please contact GSK Medical Information on 1800 033 109. GlaxoSmithKline Australia Pty Ltd. Melbourne, VIC. Trade marks are owned or licensed to the GSK group of companies © 2020 GSK group of companies or its licensor PM-AU-FLT- CRD-200001 Date of GSK Approval January 2020. HCW INFLUENZA VEST AUS/FLU6/0029/16h / i QTY Medium __________________ QTY Large _____________________ INFLUENZA HCW influenza program coordinator vests can be ordered in large or medium. Please note maximum of 6 per order • • HCW INFLUENZA THERMOMETER POSTER AUS/FLU6/0029/16c QTY __________________________ INFLUENZA An A3 poster poster to help track the influenza vaccination uptake