Get Appendix 6 Undertaking Declaration Form

The Appendix 6 Undertaking Declaration Form is a crucial document for new recruits, clinical personnel, students, and volunteers within NSW Health. This guide will provide comprehensive steps to help users complete the form online with clarity and confidence.

Follow the steps to effectively complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Read through the introduction and the requirements of the NSW Health Occupational Assessment, Screening and Vaccination against Specified Infectious Diseases Policy carefully. Ensure you understand the obligations before proceeding.
3. In the Undertaking/Declaration section, indicate whether you understand the requirements and if you consent to assessment. Choose one of the following options: 1) you have no personal circumstances preventing participation, or 2) you have medical contraindications and can provide documentation.
4. Provide your hepatitis B protection status by selecting the relevant option based on your vaccination history and serology results. Ensure all information aligns with the guidelines provided in the form.
5. Read and acknowledge your understanding of the risks of infection, consequences of infection, and management procedures in case of exposure. Agree to comply with protective measures set by the health service.
6. Complete the declaration section by writing your full name, worker cost centre (if available), date of birth, worker/student ID (if available), email, and the name of your NSW Health agency or education provider.
7. Sign the form and enter the date of completion to finalize the document.
8. Once all fields are completed, save your changes. You can then download, print, or share the completed form as needed.

Complete your Appendix 6 Undertaking Declaration Form online today for a smooth start to your employment or clinical placement.