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GU Health Onsite Flu Clinic Booking
GU Health Onsite Flu Clinic Booking
Clinic Details Form – GU Health
Step 1 of 4
In which State or Territory will this clinic be held?
Australian Capital Territory
New South Wales
Please note that each site/office/business will require a new form.
Please enter the name of the company i.e Acme Pty Ltd
This is required for clients who have multiple sites.
Address for this clinic
Building Name and/or Floor/Unit Number
Site Contact Person
What is the name of the site contact
Phone Number (office)
Phone Number (mobile)
How many clinics will you need at this location?
Please enter a value between
Please note that additional charges may apply for locations where more than one clinic is requested.
How many staff work at this location?
Please indicate the total number of staff (Headcount) working at this location.
How many staff are you expecting to get vaccinated at this location?
Please note that the number of staff being vaccinated will determine the length of your clinic. We allow 15 minutes for every 8 people (minimum clinic length is 30 minutes).
Corporate Care recommends that unless you have data from past clinics, you should estimate that 35% of staff will get vaccinated. If you estimate a participation rate greater than 35% of your staff but less than 80% of the estimated number of vaccines are administered, Corporate Care will invoice you for 80% of this estimate. If you require a longer clinic than your numbers suggest, we are happy to provide this for an additional fee. Please advise us in the ‘other details’ area on page 3 of this form.
I have requested a clinic where the number of participants is estimated to be below 20. In the event that the number of vaccines administered is less than 10 (or 15 for clinics in the Northern Territory or regional areas), I understand that Corporate Care will invoice us for 10 vaccinations (or 15 in the Northern Territory, Tasmania or regional areas).
This will apply unless otherwise stated in the quotation.
Your participation rate (%) is estimated to be:
You have requested a clinic where the participation rate is estimated to be greater than 35%. Do you acknowledge that additional nursing time may apply if less than than 80% of the estimated number of vaccines are administered?
Where will the clinic be held?
eg meeting room, first aid room, board room, Level 21, room 7.05
What type of appointment system would you like?
Our online booking system is a great option for staff who have access to computers, but in many workplaces, staff are mobile and don’t have ready access to a computer. In these circumstances, a manual booking system is a great alternative where a staff can simply put their name on a manual booking sheet.
Corporate Care has a responsibility to provide a safe working environment for our staff. Your assistance is sought to help us identify and control any risks in your environment that may that may impact upon the safe delivery of services by our staff for your staff.
Are the floor surfaces where the clinic be held flat, even and dry and floor coverings in good condition?
Is the area where the clinic be held adequately lit and ventilation adequate?
Are exit signs in the vicinity of the clinic visible?
Are emergency evacuation signs displayed in common areas of the building?
Does the workplace have emergency wardens and nominated first aid officers?
You have answered ‘NO’ to at least one ‘nurse safety’ question, please provide information that will help manage the risks to our nurse while at your workplace
Please indicate the days which are NOT suitable for your clinic
Saturday (additional fees apply)
Sunday (additional fees apply)
Please indicate the times which are NOT suitable for your clinic
Before 0700 (additional fees apply)
0700 – 0800
0800 – 0900
0900 – 1000
1000 – 1100
1100 – 1200
1200 – 1300
1300 – 1400
1400 – 1500
1500 – 1600
1600 – 1700
1700 – 1800
After 1800 (additional fees apply)
Indicate when is NOT good for our team to visit your office/premises
Is this clinic able to be held during school holidays?
NSW/ACT/WA/SA School holidays 14th April – 30th April.
VIC/QLD School holidays 30th March – 15th April
Is carparking provided for the nurse?
No (please use nearby paid parking and invoice us)
No (free street parking is available)
If parking is not provided and the nurse incurs parking expenses, these will be passed onto the client at cost
Please provide details to assist the nurse to access the parking you are providing. Be as specific as you can, particularly for CBD offices.
Is there any other information that would assist us to arrange your clinic?
I.e Is your business or office difficult to find? Do we need further instructions? Or perhaps, we need to contact security to grant us access? Do you need Nurse’s ID check prior for security reasons?