Get Aefi Reporting Form

The Aefi Reporting Form is essential for reporting adverse events following immunization. This guide provides clear, step-by-step instructions to assist users in filling out the form accurately and efficiently online.

Follow the steps to successfully complete the Aefi Reporting Form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. At the top right corner of the first page, select either ‘Initial report’ or ‘Follow up report’ by checking the appropriate box. If it is a follow-up report, ensure to specify the Unique Episode Number as required.
3. In section 1a, leave the Unique Episode Number blank unless designated to provide it. For section 1b, the Region Number should also be left blank if it does not apply to your area.
4. Enter the IMPACT LIN in section 2 if applicable; otherwise, leave blank.
5. Ensure the information in section 3 is confidential and is not sent to the Public Health Agency of Canada.
6. In section 4a, indicate the Province/Territory where the vaccination was administered. Record the date of vaccination in the specified format (YYYY/MM/DD) under section 4b.
7. Complete section 4c by providing the Dose Number of the vaccine, ensuring that it follows the established sequence (1-5) as appropriate.
8. In section 7a, indicate the highest impact the AEFI had on the patient's daily activities, as assessed by the patient or their caregiver.
9. For section 9, describe the adverse event details by checking all relevant signs and symptoms that apply, recording the interval from immunization to onset.
10. Finally, review all sections for accuracy. Save any changes made to the form, and you can choose to download, print, or share the completed document as required.

Start filing the Aefi Reporting Form online today to ensure accurate reporting of adverse events following immunization.