Get Au Tga D1073 2018-2025

The AU TGA D1073 form is designed for reporting suspected adverse reactions to medicines or vaccines. This guide provides clear and concise instructions on how to accurately complete this form online, ensuring that your report is submitted correctly and efficiently.

Follow the steps to complete the AU TGA D1073 form online.

1. Click the ‘Get Form’ button to obtain the form and open it in your chosen editing tool.
2. Begin by entering the patient's initials or medical record number in the designated field.
3. Select the patient's sex by choosing 'M' for male or 'F' for female.
4. Input the patient's date of birth or age to provide necessary demographic information.
5. Enter the patient's weight in kilograms, as this information can be relevant for evaluation.
6. List the suspected medicines or vaccines taken by filling in the appropriate fields, including dosage, trade names, batch numbers, and AUST R or AUST L numbers if known.
7. Indicate the date that treatment with the suspected medicine or vaccine began and the date it was stopped, along with the reason for its use.
8. Document any other medicines or vaccines taken at the time of the reaction, following the same format as step 6.
9. Provide details of the reaction experienced, including dates of onset, seriousness (e.g., life-threatening, hospitalization), and treatment initiated for the reaction.
10. Conclude by filling out the contact details, including name, address, postcode, and signature along with the date of submission.
11. After ensuring all sections are complete, save changes to the form. You can then download, print, or share the form as required.

Be proactive in monitoring therapeutic safety—fill out your AU TGA D1073 form online today!