Register User`s Manual (for Users without Internet access)
Contents
1. Click on the menu item Register Number Find a person s Given name Q fever immune status Family name Date of birth View and print the person s Q fever immune status report Log off the Register Running a Screening and Vaccination Program Enrole new or existing staff ina Q fever soreening program First soreening visit Collect blood and administer At the same time give them a copy of the Fact Sheet skin test and Personal Details and Consent Form Second screening visit one week later Collect signed Read skin test and Personal Details and Consent Fomes vaccinate if required Collect required documents Personal Details and Consent Form Screening Test Results Vaccination Record Log on to the Australian Q Fever Register Web Site http www qfever org Select Enter details from the Register a New Person Personal Details and Consent Form from the main menu Record Q Fever Register Number on the top of the Consent Form Select the Enter Sceening Test Results Add Test Results button Test results and vaccination record may be combined on the Pre screening and Vaccination Protocol Record the File Reference Numbers on the Test Results sheet or the Pre screening and Vaccination Protocol Select the Enter Vaccination details Add Vaccination data button Record the File Reference Numbers on the vaccination record or the Pre screening and Vaccination Protocol Mail documents to2. 14 Fixing Mistakes esiciccssdasccunseccasstcacisavanscacceusnstaansnanandncdacustssaanstanaaaacaeusiance 14 Deleting MECOTAS iii ajalik vaaata ia aaa aatal 14 REMOVING a User s ACCESS intu un nrdnan ndaniaa n dim akna ni kana 14 Removing an Organisation s ACCESS nnnnnnnnnnnnannnanannnnna 14 Getting Help AMMEEEMEMSAMESEEEA TA 15 2 User s MANU all cscscecsescccecsedecsteesceasteeaduccucessscevcusesceveusedeaeuaeauetdedeeuesdeaveus ed 15 WebSitesi E AA AA AES a taa aa 15 OHELIME EL nahkade kvartaalide usklikele 15 EMAS PP OLA 31 e TA A AIA a teea ee aae 15 The Australian Q Fever Register Help Line eeeeeennnnnannnnaa 15 Contact Details enenesenene sanee enesesse nee 16 Appendices forms for download 17 INTRODUCTION The Australian Q Fever Register is owned by the Australian Meat Processor Corporation AMPC www ampc com au It was established to assist users to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace It consists of a database containing the immune status details of individuals as determined by testing or vaccination The database can be accessed by registered users over the Internet This manual explains the use of the Register and includes sections on how to submit data to the Register
3. Date of birth Address Type of job Date of any Q Fever Vaccination administered Date and results of any Q Fever tests performed Date of laboratory confirmation of any diagnosis of Q Fever disease 2 Iwill be issued with a Q Fever card which includes my Name Date of Birth Q Fever Register Number A Fever Immune status and the date the card was issued will also receive a copy of the information held by the Register and have an opportunity to correct any errors 3 Employers meat processors will be able to access my personal information held by the Register for the purpose of confirming my immune status e Employers can only access my information if they know my name date of birth and Register Number e Employers can only find my Register Number if i Itellthem or ii They electronically submit the information in this consent form to the Register using the Internet 4 IfI have been previously tested or vaccinated my employer or doctor may contact the site at which the screening vaccination took place and reguest copies of my relevant medical records 5 The information on this form will be either submitted to the Register by my current employer after which this signed original consent form will be lodged with the Register or mailed by me directly to the Register Information may be submitted and my details accessed over the Internet Secure connections and passwords ensure that only authorised employers are able to submit information
4. You have had the disease in the past you may not know this if it was a mild case Q Fever and the Workplace e Your employers will want to and need to make sure you are protected from Q fever e f you change jobs your new employer will want to make sure you are protected from the disease before you start work e f you don t have proof of vaccination you will need to be tested The test is expensive and takes over a week to get the results which means you shouldn t start work straight away The Register e The Register was set up to help workers and employers prevent Q fever and make it easier when starting a new job e The Australian Q Fever Register has been established to store details about vaccinations test results and disease If you are on the Register employers can quickly check your immune status and you can start work straight away without any testing e If you are not on the Register you may need to be re tested when you change jobs e Noone can see or use the information on the Register without your permission Want to know more This fact sheet contains answers to common questions about e Q fever and e The Australian Q Fever Register If you need more information contact details for the Register are on the last page Q Fever and the Australian Q Fever Register Fact Sheet Page 1 of 4 The Disease What is Q Fever Q fever can be spread to humans mainly from cattle sheep and goats The germ is spread in t
5. house name rural location e Town Suburb Be careful of the spelling as this will be checked against Australia Post s postcode database and rejected if incorrect e State Select the abbreviation from the drop down list If the address is overseas use OS e Postcode This space must contain four digits for Australian addresses e Country This defaults to Australia but you can delete this and type a different country in cases where the person s normal postal address is overseas e Secret Question Select one of the questions from the drop down list e Answer This is the answer to the selected secret question e Job type Select from the drop down list e Consent to be contacted A person may tick the box on the consent form indicating that they are willing to be contacted for further research Submitting Test Results and Vaccination Details The easiest way to record Screening Test Results is to use the Pre Screening and Vaccination Form This contains all the information required by the Register as well as other organisations eg for the employer s and Doctor s records or for State Departments of Health This form contains information about both screening tests and vaccinations If you use this form you can photocopy it and submit a copy to the Register with the original of the Personal Details and Consent Form If the Pre Screening and Vaccination Form is not used it is still possible to send screening test and vacci
6. more information contact the Q Fever Register Help Line or visit the Q Fever Register Web site Australian Q Fever Register Help Line 1300 QFEVER 1300 733 837 Or 07 4688 2610 Fax number 07 4688 2699 Australian Q Fever Register Web site http www gfever org Postal Address Australian Q Fever Register PO Box 1278 Toowoomba QLD 4350 Australian Q Fever Register Application for Access Version 15 04 2015 Page 3 of 3 Australian Admin Use Only User Number Q Fever Register Australian Q Fever Register User Registration The Australian Q Fever Register is owned by the Australian Meat Processor Corporation AMPC Its purpose is to assist organisations to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace To access the Register an organisation must complete the Application to Access the Register form sign the declaration and nominate one or more individuals as Registered Users using this form Allthe information on this form is reguired User Details Title Mr Ms etc Date of Birth day month year Name Given Name Family Name Organisation Position Telephone E mail Identification Security Question Mother s maiden name her name before she was married If you telephone the register you will be as
7. the Register Origins Consent Form no copies retsined and either Pre screening and Vaccination Protocol or Copy of Test Results and Copy of Vaccination Record GETTING ACCESS TO THE REGISTER Registering an Organisation The Register provides information to help protect people in at risk groups from contracting Q fever The Register is therefore designed to be available to organisations working with people in these at risk groups The main organisations requiring access to the Register are meat processors and medical practices that provide screening and vaccination services to people at risk of exposure to Q fever Other organisations may be provided access if required for example state government health departments who directly provide screening and vaccination services In order for an organisation to access the Register it must complete the Application for Access to the Register form Appendix A and mail it to the Register All parts of this form must be completed The form should be signed by a person who has been authorised by the organisation s board of directors to sign on their behalf The Terms and Conditions of access to the Register are attached to the form and these should be read before signing The terms and conditions aim to e Encourage the submission of all available relevant information from consenting individuals to the Register e Ensure that data on the Register is of the highest quality e Protec
8. the Register Web site Users should read the Terms and Conditions of access to the Register before signing the form Once completed the User Registration form s should be sent along with the Application for Access to the Register Access without the Internet The Register is designed to be accessed suing the Internet and all users are strongly encouraged to use this method of access You can also access the Register by phone or by mail if you do not have Internet access You can find out about a person s status by phoning the Register help line You can submit data to the Register by mailing or faxing it to the Register Important note Using the Internet most operations of the Register are automated making it fast and inexpensive to operate Telephone and mail access put an increased load on staff making the system more expensive Users are therefore strongly encouraged to access the Register using the Internet wherever possible The Register offers no guarantee that telephone and mail access will be provided indefinitely and heavy staff workloads may mean that running costs have to be passed on to users in the future SUBMITTING DATA Submitting data to the Register without internet accecss Submitting data to the Register involves Collecting the data by completing the Personal Details and Consent Form and the Pre Screening and Vaccination Form Sending the completed forms to the Register by mail or fax For the Person
9. the change A new User may be nominated on the User Registration form at the same time if required As acheck any users who have not accessed the Register for at least 6 months will be contacted to check if they are still eligible to be Registered users If not their accounts will be deleted Removing an Organisation s Access If an Organisation no longer wishes to participate in the Register an authorised representative should contact the Register and inform staff of this decision GETTING HELP User s Manual This User s Manual has answers to most of the common questions about the operation of the Register A hard copy is issued to each organisation authorised to access the Register A copy is also available for download from the Australian Q Fever Register Web Site in Adobe Acrobat pdf format Web Site The Australian Q Fever Register Web Site contains a range of resources to help users In addition to a copy of this User s Manual there is also a link to Frequently Asked Questions FAQ about Q fever and the Register The Register itself contains links to help as described below The Web site address is http www gfever org On Line Help While using the Register some pages contain links to help pages These provide information on the procedure currently being undertaken Email Support If none of the other options are able to answer your question you can always Email the Register office with your question
10. the declaration and nominate one or more individuals as registered Users on the User Registration Form All the information on this form is required Organisation Details Organisation Name Address Street number name PO Box etc Town Suburb State Postcode Organisation Type Meat processor Medical Practice Other If Other please state Organisation type and reason for requesting access to the register Approximate Size of Organisation Approximate number of employees or for medical less than 20 21 100 101 250 practices clients at risk of being exposed to A fever 11251 500 more than 500 The Terms and Conditions of Access to the Register attached to this form aim to e Encourage the submission of all available relevant information from consenting individuals on the Register e Ensure that data on the Register is of the highest quality e Protect the privacy rights of individuals whose data is on the Register e Protect the privacy rights of Organisations seeking access to the Register Please read the Terms and Conditions attached to this form before signing the undersigned hereby apply for access to the Australian Q Fever Register certify that am authorised to sign this application for access to the Register on behalf of the above named Organisation and agree to be bound by t
11. Australian A Fever Register User s Manual for users without Internet access April 2015 CONTENTS COMEM AIAMAA 2 Tai ieole tes i 0 9 EEA 4 QUICK Start Guide incisiscnctentiscncsnistanszentecosenncnmtarnaeseceeanes 5 Checking a Person s Stat S ccseisscisseiscssssessececeadcecsssesasnsieesawesssiiaensieuiannwane 5 Running a Screening and Vaccination Program ccccsssssssseeeeeeteees 6 Getting Access to the Register ccccsssssseeesesseees 7 Registering an Organisation n nnnnnnnnennnnnnnnnnannnnaanenmnnnnnnnna 7 Registering a USER kraatrist m kil 7 Access without the Internet 20onenennnnnnannnnnannnnnnnnnnnnnnnnnas 8 Submitting Data 101010100000nnnnnnnnnnnnnnnnnnnnana 9 Submitting data to the Register nnnnnnanennnnnnnnnnnnnaaannenss 9 Personal Details and Consent Form nennnnnnnnnnnnnnnnannnnnnnnnnna 9 Submitting Test Results and Vaccination Details 10 Submitting A Fever Disease Information nnnnnnanannnns 11 Querying the Register cccsccececssssssesssneseeeees 12 Finding a Person s Q Fever Register NUMber ccceeeeeeeeeeeeeeeeeeeeeees 12 Finding a Person s Status siesciesccanciananencisnsnancuansiancucnciensnenenensnenciensusisinens 13 Special ProcedureS ssssssssssnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn
12. Corporation AMPC Its purpose is to assist organisations to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace To be included on the Register you must complete and sign this consent form Please do not leave any blank spaces all the information is required Give the completed form to your employer to register your details or send it to the Australian QFever Register with a copy of your medical evidence that confirms your Q Fever Status Personal Details Please print clearly Legal name only as shown on birth certificate or passport Gender Male Female Phone number Name Given Name Other Names Family Name Date of Birth Postal Address Day month year Street number name PO Box RMB Flat number etc Town Suburb State Postcode Country Identification Security Question Mother s maiden name her name before she was married If you telephone the register you T h b 4 will be asked this question to own wnere you were born confirm your identity Tick one y ANSWER of these four questions that Town where your spouse was born nobody else is likely to know the i 2 answer to Your first pet s name Write the Answer to the guestion you ticked here Type of Job Plea
13. Occupational Health and Safety of employees of the Organisation Nominated staff members details will be submitted to the Register using the User Registration Form 4 2 Ensure that authorised Users comply with the requirements of these Terms and Conditions 4 3 Ensure that the passwords used by authorised Users are kept secret and will take all necessary steps to prevent non authorised persons from accessing the Register 4 4 Notify the Register within 7 days of the termination of employment of an authorised User so their access rights can be removed New nominations for authorised Users may be submitted at any time however no more than two authorised Users per workplace will normally be permitted unless reasonable need for more Users is demonstrated by the Organisation 4 5 Provide all necessary facilities and equipment to authorised Users to enable them to submit data to and access data from the Register This will include where possible internet access and E mail Where Internet access is not feasible authorised Users may contact the Register using facsimile telephone and mail Note that the Register does not guarantee to support non Internet access indefinitely 4 6 Ensure that information from the Register is used only for the purpose for which it is intended 5 Submitting data 5 1 Whenever information about the Q Fever immune status of an associated individual becomes known to the Organisation through screening programs vaccinatio
14. Personal Details and Consent Form Version 15 04 2015 Page 2 of 2 Q FEVER PRE SCREENING AND VACCINATION FORM Please print clearly Given Names Family Name Date of Birth Sex Male Female Series Number Employer Blood Test Please attach pathology results to this form Venipuncture Date Pathology Service Results interpreted by Provider No Date Test Positive Negative Pathology Q Fever Register Result Indeterminate Serial Number File Reference Comment Skin Test Date Il By Batch Expiry administered whom No date Results interpreted by Provider No Date read Diameter of Result Positive Negative Q Fever Register Induration Indeterminate File Reference Comment Date given Batch No Expiry date Register file ref no Complete vaccine 0 5ml A l Vaccinator Provider No Signature Spilt vaccine part 1 0 1ml I l l Vaccinator Provider No Signature Split vaccine part 2 0 4m l Vaccinator Provider No Signature Post vaccination adverse effects Any post vaccination adverse effects should be reported to bioCSL Medical Information on 1800 642 865 Q Fever status Tick status Explanation Contiimedexpos re Positive to blood or skin test OR equivocal test results react
15. Register Standard Operating Procedures SOPs which form part of these Terms and Conditions The SOPs are updated from time to time and the latest version can be found on the Australian Q Fever Register Web site http www qfever org 4 Authorised Users A registered Organisation will 4 1 Nominate staff member s as authorised Users of the Register Nominated staff members will normally be employed with responsibility for the Occupational Health and Safety of employees of the Organisation Nominated staff members details will be submitted to the Register using the User Registration Form 4 2 Ensure that authorised Users comply with the requirements of these Terms and Conditions 4 3 Ensure that the passwords used by authorised Users are kept secret and will take all necessary steps to prevent non authorised persons from accessing the Register 4 4 Notify the Register within 7 days of the termination of employment of an authorised User so their access rights can be removed New nominations for authorised Users may be submitted at any time however no more than two authorised Users per workplace will normally be permitted unless reasonable need for more Users is demonstrated by the Organisation 4 5 Provide all necessary facilities and equipment to authorised Users to enable them to submit data to and access data from the Register This will include wherever possible a computer with an Internet connection and appropriate Web browser softw
16. able measures to ensure the accuracy of the information entered onto the Register 5 6 Where no Internet access is available the Consent form and other immune status documentation will be mailed to the Register for data entry 5 7 Where an Organisation holds information about the immune status of individuals collected prior to the commencement of the operation of the Register that Organisation shall request for current employees and where possible for former employees signed consent to submit such details to the Register A signed Consent form is required before any data can be entered on the Register Australian Q Fever Register User Registration Form Page 2 of 3 6 Storage and Handling of Records 6 1 Once the data from Consent form has been entered onto the Register the Consent form will be sent to the Register No copies of the Consent form will be kept by the Organisation 6 2 Information concerning the Q Fever status including copies of the Pre Screening and Vaccination Form may be kept by the Organisation in the individual s medical record but a copy must also be submitted to the Register by mail after it has been entered onto the Register 6 3 Medical records retained by the Organisation should be stored securely so as to ensure that they are accessible only to personnel authorised to do so and are only used for the purpose for which they were collected 7 Access Authorised Users may access information held by the Regis
17. al Details and Consent Form the signed original must be sent to the Register and no copies kept by any organisation other than the Register For the other documents copies may be sent to the Register Four types of data may be submitted to the Register Personal details Screening test results Vaccination records Disease confirmation information Personal Details and Consent Form Gender Male or Female Given name This is the name chosen by the person s parents In Western cultures this is a person s first name In some Asian cultures this may be the name which normally comes last Other names These are other names usually middle names This may be left blank if the person has no middle names Family name This is the last name for Western cultures In some Asian cultures it may normally be written first Date of Birth This is written in digits with or without a leading 0 and using four digits for the year For example 3 4 November 1965 would be written as 3 11 1965 Address This is the first lines of the person s postal address Don t write the town suburb state or post code in this box as they are entered separately Normally this is a house number and street name eg 39 Camellia Way but it may include e unit numbers 2 43 Smith Parade e post office or other box numbers PO Box 23 RMB 2892 e several lines of additional address information eg a business name floor or suite number of a building
18. aling with indeterminate test results Diameter of induration Recorded in millimetres Q Fever Register File Reference See explanation under Blood test section Indeterminate test results The Q Fever vaccine provider suggests that indeterminate test results be followed by re testing OR by exposure of the subject to split dose vaccination using a small starting dose 5 ug or 0 1 ml and checking for reaction and then moving to a second split dose of 20 ug 0 4ml e Details on these procedures may be found in the Australian Immunisation Handbook 10th Edition 2013 under Section 4 15 See www immunise health gov au 5 Vaccination Vaccination may be administered in one of three ways single administration of a complete vaccine dose 25 ug or 0 5 ml or by administration of one or two split doses of vaccine for people with indeterminate test results Vaccine batch number Should be entered as displayed on the vaccine container Q Fever Register File Reference See explanation under Blood test section Uncommon reactions These should be reported to CSL on the number given Historic exposure A small number of people each year present with unverified history of prior vaccination or natural exposure and yet produce negative or equivocal test results on blood and skin tests Explanations may range from forgetfulness where individuals may believe they have been vaccinated or exposed when in fact they have not to the situation where individu
19. als have been vaccinated exposed and test negative because of the waning of immune reactivity over time e Vaccination is contraindicated if individuals have been previously vaccinated or exposed Vaccination is required for protective immunity if individuals are testing negative because they have not been previously vaccinated or exposed e Itis suggested that Doctors review these cases and discuss options and risks with individuals Relevant information includes age of the patient and work life history that may increase likelihood of prior exposure or vaccination If the Doctor is confident that the patient is likely to have immunity despite a negative test then the Doctor can recommend a classification of Historic exposure This will allow the Register to enter the individual and issue a Q Fever card This can only be done if the Doctor and patient sign the Historic exposure box acknowledging review and a considered decision ene 01 7 No vaccination e Reason why the person was not vaccinated 8 More information e Doctors may seek further information on this matter by calling the Register for referral to a health professional with expertise in A Fever infections or by visiting the Q Fever website to review information including links to the Australian Immunisation Handbook and to technical information on the Q Fever vaccine provided by the vaccine manufacturer What to do with this form 1 One copy of the form should be
20. and Vaccination Form Who should complete this form The form should be completed by the medical staff carrying out the testing and vaccination procedures Explanation of form contents 1 Personal Details e Series Number This is an optional number used by an organisation eg meat processor to track individuals going through a screening and vaccination program e Employer The employer name if the testing and vaccination is funded by the employer Employers may wish to produce copies of this form with their name already printed in this space 2 Blood test e Test result Result should be recorded as positive or negative or indeterminate See below for advice on dealing with indeterminate test results e Pathology serial number An optional reference number issued by the pathology laboratory e Q Fever Register File Reference This number is displayed by the Register once results are entered into the Register through the web portal This should only be completed if the person has signed a Q Fever Register consent form and the information has been submitted to the Register on the Internet e Pathology Results These should be attached to this form and filed by the doctor A copy may also be kept by the employer It is not necessary to send a copy of the pathology results to the State Health Department or the Q Fever Register Skin test Test result This should be recorded as positive or negative or indeterminate See below for advice on de
21. and how to retrieve data from it The Register is designed to be quick and simple to use however as it manages personal information privacy and security are key considerations Users are asked to ensure that they closely follow all the procedures described so that the Register can operate effectively and people whose details are entered onto the Register can be assured that the Register poses no threat to their privacy QUICKSTART GUIDE This section will get you started using the Register for the common procedures Follow the flow chart for the task you want to do Checking a Person s Status You usually need to check a person s status when they are first employed in a high risk workplace You may also want to check their status before they participate in a screening program A person is accepted for employment in a high risk industry eg a meat processing plant Ask if the person has been entered on the Australian Q Fever Register Yes Not sure No Do they have their Q Fever Register Card Conduct screening tests and vaccination if required see next section Yes Do they remember their Q Fever Register Number Ask them to ring the Q Fever Register Help Line to ask for their Register Number Do they have a Q Fever Register Number Log on to the Australian Q Fever Register Web site http www gfever org Enter your user name and password to access the Register Enter the person s
22. are as well as an E mail account for each User Where Internet access is not feasible authorised Users may contact the Register using facsimile telephone and mail Note that the Register does not guarantee to support non Internet access indefinitely 4 6 Ensure that information from the Register is used only for the purpose for which it is intended 5 Submitting data 5 1 Whenever information about the Q Fever immune status of an associated individual becomes known to the Organisation through screening programs vaccination programs or notifications of disease the Organisation will seek the individual s consent to enter such details on the Register 5 2 Consent will only be considered to have been granted if the individual reads and signs the Australian Q Fever Register Personal Details and Consent Form The Organisation should make every effort to explain the benefits and use of the Register to individuals Individuals should be encouraged to provide their consent but no individual should be compelled to participate in the Register 5 3 When new immune status information is obtained about an individual who has previously provided signed consent there is no need for further consent to enter the new information on the Register 5 4 Where Internet access is available authorised Users are responsible for entering the details provided on the Consent form and immune status information onto the Register 5 5 Authorised Users shall take all reason
23. e any information Please make every effort to ensure the details order of names spelling date or birth etc are correct The Q Fever Status Report contains the following information e Fullname e Date of birth e Q fever status This may be e Vaccinated e Confirmed Exposure where there has been a positive test result but no vaccination recorded e Tested Negative where there has only been negative test results or Incomplete Record where a Register entry exists but no vaccination or test results are present You may request a copy of the Status Report to be faxed mailed or emailed to you if required SPECIAL PROCEDURES Fixing Mistakes If you discover a mistake in the data on the Register you should contact the Register on the Register Help line to explain the problem and ask that it be corrected The Register staff will then make any changes necessary Deleting Records If a person wishes to have their record removed from the Register they should ring the Register Help Line Removing a User s Access If a user stops working for an organisation or changes their area of responsibility and no longer works with the Register their user account will be deleted to prevent unauthorised access to the Register data As soon as an existing user no longer works for the organisation or no longer has responsibility for the accessing the Register the Organisation should contact the Register to inform the staff of
24. ed with a Q Fever Register card which includes their status at the time of issue and their Register Number If a person has their Q Fever Register card they can tell you their number from the card If a person doesn t have their card on them and can t remember their number you should ask them to phone the Q Fever Register Help Line 1300 QFEVER to find out what their number is Once they identify themselves with their secret question and answer they will be told their number which they can then give to you You may not request a person s number on their behalf staff of the Register will only provide Q Fever Register Numbers directly to the person concerned Finding a Person s Status To find a person s status you can call the Australian Q Fever Help line You will be asked to identify yourself as a registered User of the system which means you will have to provide your name and the answer to your secret question Once you have confirmed that you are authorized to use the Register you can find out details of a person on the Register You will be asked for the following details e Q Fever Register Number e Given name This may not be the first name in some cultures e Family name This may not be the last name in some cultures e Date of birth If all the details are correct you will be told the person s status and the details held in the Register If all the details do not match exactly the Register will not provid
25. firmed by laboratory testing Diagnoses made solely on the basis of clinical signs and history are not adequate proof that the person has had Q Fever The data required is the date on with the diagnosis was confirmed and the type of test used to confirm the diagnosis skin or blood You will need to submit a document containing this information to the Register either a pathology test result a doctor s certificate or both QUERYING THE REGISTER The main purpose of the Register is to find out the Q fever immune status of a person To do this you need the four pieces of information to identify an individual e Their Q Fever Register Number e Their given name e Their family name e Their date of birth Finding a Person s Q Fever Register Number A person s Q Fever Register Number acts like a key to the information on the Register Without this number you can t access the information If you want to access the information you have to ask the person for their Register Number When a person gives you their number they are consenting to you accessing the information IMPORTANT Just like a real key the system is no longer secure if the number falls into the wrong hands You should therefore treat a person s Q Fever Register Number as private information and you must not keep a paper or electronic copy of anybody s number nor reveal their number to anybody else Everybody who is entered onto the Register is issu
26. gned Consent form is required before any data can be entered on the Register Australian Q Fever Register Application for Access Version 15 04 2015 Page 2 of 3 6 Storage and Handling of Records 6 1 Once the data from Consent forms has been entered onto the Register the forms will be mailed to the Register No copies will be made or kept by the Organisation 6 2 Copies of Immune Status Documentation may be kept by the Organisation in the individual s medical record but a copy must also be submitted to the Register by mail after it has been entered onto the Register 6 3 Medical records retained by the Organisation should be stored securely so as to ensure that they are accessible only to personnel authorised to do so and are only used for the purpose for which they were collected 7 Access Authorised Users may access information held by the Register under the following conditions 7 1 Access to information on an individual is only permitted with the consent of that individual 7 2 Consent to access information shall be considered to have been granted if the individual informs the Organisation of their Q Fever Register Number full name and date of birth 7 3 The Organisation shall not keep records of the Q Fever Register Numbers of individuals nor reveal these numbers to any other individual or Organisation 7 4 The Organisation shall ensure that any information on an individual that has been obtained from the Register is n
27. he Terms and Conditions attached to this application further accept responsibility for ensuring that any employees of this Organisation who are granted access to the Register adhere to the attached Terms and Conditions Signed Date Name printed Position Once this page is completed and signed it should be faxed or mailed to the Australian Q Fever Register accompanied by one or more User Registration Forms that provide the details of authorised Users Do not send the Terms and Conditions pages 2 amp 3 of this document to the Australian Q Fever Register these pages are intended to be read before signing Australian Q Fever Register Application for Access Version 15 04 2015 Page 1 of 3 Terms and Conditions of Access to the Australian Q Fever Register do not return pages 2 amp 3 the Terms 8 Conditions to the Australian Q Fever Register Definitions applying for the purposes of these Terms and Conditions Register means the Australian Q Fever Register User means an employee of a registered Organisation who has been authorised by that Organisation and the Register to submit and retrieve data from the Register 1 3 Organisation means a legal entity under Australian law eligible to be granted access to the Register ie a registered meat processing plant medical practice or other Organisation as determined by the Australian Q Fever Technical Management Committee 1 4 Associated individual means a pers
28. he urine faeces and milk but birth fluids the foetus and the placenta are the most dangerous sources People can become infected by contacting ingesting or breathing in infected material When infected some people experience no signs while others just feel a little off colour for a few days Many people may feel like they have a bad case of the flu with fever and sweating nausea vomiting and diarrhoea for several days For most people these signs pass and there are no more problems More severe disease may occur in people with other conditions such as pre existing heart conditions It is very rare for anybody to die of Q fever although some people may get other problems months or years after the first signs of disease have passed These take the form of extreme tiredness and weakness even after minor exercise muscle pains headaches fever and depression This form of the disease Post Q Fever Fatigue Syndrome may last for years and may be debilitating Are you immune to Q Fever You are probably immune to Q fever and should not get the disease if you have ever had e avaccination against Q fever e atest to say that you are immune or e the Q fever disease diagnosed by a doctor and confirmed by a blood test requested by a doctor If you don t know if you have had the disease or a vaccination against it then your employer will ask you to have a test to check if you are immune If you aren t immune then you will probably need t
29. information will not be released or sold for any commercial or marketing purpose No information will be released to any government authorities except in the following circumstances e where a government authority acts as a registered screening and vaccination service provider or e where there are reasonable grounds to believe that disclosure is necessary to prevent a threat to life or health For more information contact the Q Fever Register Help Line or visit the Q Fever Register Web site Australian Q Fever Register Help Line 1300 QFEVER 1300 733 837 Or 07 4688 2610 Fax number 07 4688 2699 Australian Q Fever Register Web site http www gfever org Postal Address Australian Q Fever Register PO Box 1278 Toowoomba OLD 4350 Information for Employers and Medical Practitioners Please give a copy of this form to all employees clients involved in A Fever screening and vaccination programs along with a copy of the Fact Sheet A Fever and the Australian A Fever Register and invite them to participate in the Register Note that a signed consent form is reguired for submission of information to the Register along with evidence of testing and vaccination status More information is available on the web site or by contacting the Register Help Line Detailed instructions for how to submit completed paperwork to the Register can be found on the Register web site or by calling the Register Help Line Australian Q Fever Register
30. ion p to vaccine split part 1 Vaccinated Either complete vaccine in a single dose OR part 1 part 2 of vaccine split dose A Test negative with history of prior vaccination or exposure that Historic exposure cannot be documented Requires signatures see below No Status Individuals who do not meet other criteria have an unresolved status and will not be entered onto the Register Historic exposure have reviewed this patient s case and believe he she is likely to be immune to Q Fever because of prior vaccination or exposure despite returning negative or equivocal test results recommend this patient be issued a Q Fever card under the category Historic exposure Doctor Provider Number Date Year vaccinated exposed Signature Patient signature Please tick a reason if vaccination did not occur O Tested positive blood or skin O Historic exposure see above O Medically contra indicated O Employee refused Please read the instruction sheet following page for more information on how to use this form Once completed send this page only back to the Register Do not send the instruction page to the Register Australian A Fever Register Pre Screening 8 Vaccination Form Version 15 04 2015 Instructions for the Q Fever Pre Screening and Vaccination Form do not send this page back to the Register This page provides detailed information to guide completion of the Q Fever Pre Screening
31. itions shall apply 1 1 Register means the Australian Q Fever Register 1 2 User means an employee of a registered Organisation who has been authorised by that Organisation and the Register to submit and retrieve data from the Register 1 3 Organisation means a legal entity under Australian law eligible to be granted access to the Register ie a registered meat processing plant medical practice or other Organisation as determined by the Australian Q Fever Technical Management Committee 1 4 Associated individual means a person associated with the Organisation for example as an employee contractor visitor client or patient 1 5 Consent form means the Australian Q Fever Personal Details and Consent Form 1 6 Immune Status Documentation means any documentation that provides reliable information on the Q Fever immune status of an individual primarily vaccination certificates pathologists test results or medical certificates 2 Purpose The purpose of the Register is to assist Users to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace The function of the Register is to store and report information on the Q Fever immune status of individuals in order to achieve the purpose as outlined 3 Standard Operating Procedures The Organisation will adhere to the procedures and rules layed out in the Australian Q Fever
32. ividual has previously granted consent to be contacted for research purposes 9 3 Organisations may be contacted to request their participation in approved research but they are under no obligation to do so 10 Discrimination The Organisation will ensure that no individual is discriminated against in any way on the basis of the presence or absence of information on the Register failure to inform an employer of their Q Register Fever Number or due to the content of the information on the Register 8 Monitoring of on line activity All on line activity on the Register is monitored and logged This is done to enable the correction of errors identify unauthorised or inappropriate use and to monitor usage patterns to help identify those Users who may be in need of further assistance To ensure data accuracy AMPC may from time to time audit data and user activity 9 Privacy All information submitted on this form or subsequently collected about an Organisation or their activities through the operation of the Register will be kept strictly confidential No information that may be identified with a particular registered Organisation will be released to any other registered Organisations businesses government departments or individuals Organisation contact details may be released to approved researchers subject to the requirements described under item 8 Research above 10 Penalties Any breaches of these terms and conditions will be referred
33. ked this question to Town where you were born confirm your identity Choose one of these four questions that Town where your spouse was born nobody else is likely to know the answer to Your first pet s name Answer to the question you chose On Line Access Do you have Internet Access Yes No If Yes what User Name do you want to use for access to the Register A temporary password will be sent to you when the application is processed You should change this to a password of your own choosing when you first log in to the Register The Terms and Conditions of Access to the Register aim to Encourage the submission of all available relevant information from consenting individuals to the Register Ensure that data on the Register is of the highest quality Protect the privacy rights of individuals whose data is on the Register Protect the privacy rights of organisations seeking access to the Register Please read the Terms and Conditions attached to this form before signing the undersigned hereby apply for registration as an authorised User of the Australian Q Fever Register agree to be bound by the Terms and Conditions attached to this application Signed Date Australian Q Fever Register User Registration Form Page 1 of 3 Terms and Conditions of Access to the Australian Q Fever Register 1 Definitions For the purpose of these Terms and Conditions the following defin
34. me date of birth and your secret question Once identified they will tell you your Q Fever Register Number and will arrange to print a replacement card if required How can you find out what information is kept on you Everybody on the Register has the right to know what information is kept and to request that any errors be corrected Whenever a Q Fever Card is issued a covering letter with the full details of the information held by the Register is sent with it This letter contains a form for correction of any incorrect details which should be sent back to the Register You can also call the Q Fever Register Help Line 1300 QFEVER identify yourself and request your details or correct errors What if you lose your Q Fever Card If you lose you Q Fever Card you can telephone the Register and ask for a new card to be issued What about discrimination In addition to the protection offered by State and Commonwealth legislation registered users of the Register employers in particular must sign an agreement stating that they will not discriminate against a person in any way either on the basis of the information contained on the Register because a person is not on the Register or because a person fails to inform them of their Register Number Who owns the Register and the data The Register and data in it are owned by the Australian Meat Processor Corporation AMPC It is operated by an independent Data Manager appointed by AMPC cur
35. n programs or notifications of disease the Organisation will seek the individual s consent to enter such details on the Register 5 2 Consent will only be considered to have been granted if the individual reads and signs the Australian Q Fever Register Personal Details and Consent Form The Organisation should make every effort to explain the benefits and use of the Register to individuals Individuals should be encouraged to provide their consent but no individual should be compelled to participate in the Register 5 3 When new immune status information is obtained about an individual who has previously provided signed consent there is no need for further consent to enter the new information on the Register 5 4 Where Internet access is available authorised Users are responsible for entering the details provided on the Consent form and immune status information onto the Register 5 5 Authorised Users shall take all reasonable measures to ensure accuracy of information entered onto the Register 5 6 Where no Internet access is available the Consent form and other immune status documentation will be mailed to the Register for data entry 5 7 Where an Organisation holds information about the immune status of individuals collected prior to the commencement of the operation of the Register that Organisation shall request for current employees and where possible for former employees signed consent to submit such details to the Register A si
36. nation results to the Register All that is needed is some form of official record of the test results eg a copy of the pathology results and the vaccination a copy of a vaccination certificate These documents must be appropriately authorized eg signed by a medical practitioner Screening tests always consist of both a blood test and a skin test and both results are required before you submit the data to the Register If only blood test results are available for instance the person did not return for the skin test to be read the blood rest result can be entered on its own only if e the result is positive and e The result is unequivocal ie the medical staff interpreting the result are confident that the result is truly positive without the need for a skin test to confirm the result The information required about each test consists of the date that the test was performed and the test result either positive or negative The information required about vaccination is the date of vaccination and the batch number The batch number should be entered exactly as it appears on the vaccine bottle ie BOO80 where represents a digit The batch number is required unless information from old records is being used and it is impossible to determine which batch of vaccine was used Submitting Q Fever Disease Information When a person has Q Fever data may only be entered into the Register when the diagnosis has been con
37. ntent of the information on the Register 11 Monitoring of on line activity All on line activity on the Register is monitored and logged This is done to enable the correction of errors identify unauthorised or inappropriate use and to monitor usage patterns to help identify those Users who may be in need of further assistance To ensure data accuracy AMPC may from time to time audit data and user activity 12 Privacy All information submitted on this form or subsequently collected about an Organisation or their activities through the operation of the Register will be kept strictly confidential No information that may be identified with a particular registered Organisation will be released to any other registered Organisations businesses government departments or individuals Organisation contact details may be released to approved researchers subject to the requirements described under item 8 Research above 13 Penalties Any breaches of these terms and conditions will be referred to the Australian Q Fever Register Technical Committee They may at their discretion take any action required to correct the problem Actions may include but may not necessarily be limited to requiring a guarantee that the cause of the breach has been remedied and that similar future breaches will not occur temporary or permanent removal of access rights to the Register or in the case of severe breaches recommending appropriate legal action be taken For
38. o have a vaccination to protect you from Q fever in the future The Register What is the Q Fever Register The Australian Q Fever Register is a database to store information about the Q fever immune status of people who have agreed to be part of the Register What is the Register for The purpose of the Register is to help people avoid getting the disease It does this by providing a secure record of your Q Fever immune status so both you and your employer can be confident that you are immune How will the Register help The Register will help workers by storing their vaccination or test details and by making it easier for you and your employer to document your Q Fever status at any time If you are not on the Register you will need to be tested and then if you are not already immune you or your employer can arrange for you to be vaccinated What are the benefits of being on the Register Once on the Register you or your employer can check your Q fever status at any time and you will be issued with a Q fever card that you can carry with you as a record of your Q fever status It saves the time inconvenience and cost of unnecessary testing It can also help you avoid the risks of unpleasant reactions that may occur when a person who is already immune is unnecessarily vaccinated Q Fever and the Australian Q Fever Register Fact Sheet Page 2 of 4 Whose information is on the Register The Register is designed to store information fo
39. on associated with the Organisation for example as an employee contractor visitor client or patient _ _ h ok N 1 5 Consent form means the Australian Q Fever Personal Details and Consent Form 1 6 Immune Status Documentation means any documentation that provides reliable information on the Q Fever immune status of an individual primarily vaccination certificates pathologists test results or medical certificates 2 Purpose The purpose of the Register is to assist Organisations to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace The function of the Register is to store and report information on the Q Fever immune status of individuals in order to achieve the purpose as outlined above 3 Standard Operating Procedures The Organisation will adhere to the procedures and rules layed out in the Australian Q Fever Register Standard Operating Procedures SOPs which form part of these Terms and Conditions The SOPs are updated from time to time and the latest version can be found on the Australian Q Fever Register Web site http www gfever org All Users are informed when any changes are made to the SOPs 4 Authorised Users A registered Organisation will 4 1 Nominate staff member s as authorised Users of the Register Nominated staff members will normally be employed with responsibility for the
40. ot available to third parties 8 Use of Data The Organisation shall ensure that data collected from an individual or obtained from the Register is used only for the purpose for which it was obtained that is to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace 9 Research Information on the Register may be used for Research into Q Fever under the following conditions 9 1 Applications for use of Register data for research must be made to the Australian Q Fever Register Technical Management Committee made up of industry union occupational health and safety and medical representatives If approved the request will then be evaluated by an appropriate Ethics Committee 9 2 No individually identifying data will be released unless the individual has previously granted consent to be contacted for research purposes 9 3 Organisations may be contacted to request their participation in approved research but they are under no obligation to do so 9 4 A written record of all requests for use of the Register for research will be kept by the Technical Management Committee 10 Discrimination The Organisation will ensure that no individual is discriminated against in any way on the basis of the presence or absence of information on the Register failure to inform an employer of their Q Register Fever Number or due to the co
41. r those people who test positive for Q fever or who have tested negative and have then been vaccinated for Q fever Who can access the information The Register has strict privacy controls After being added to the Register you can access the information on your own immune status by calling the Register If you give your permission the information may also be accessed by an employer or your doctor How can employers or doctors access the information Register information is stored in a database connected to the Internet Employers and doctors who have registered as users can access the Register using a Web page The Register uses commercial security systems to protect information in the same way that other services do such as internet banking Users can only access your Q fever status if they know your Q Fever Register Number a unique number for each person on the Register The only way they can get that number is if you tell them How is information put into the Register Information is entered into the Register by registered users employers or doctors or their designated staff eg an Occupational Health and Safety Nurse Before any information about you is entered you must read understand and sign a Q Fever Personal Information and Consent Form This form contains basic information to identify you and shows that you have agreed to be entered on the Register If you don t want to be entered on the Register you don t have to complete
42. rently AusVet Animal Health Services Pty Ltd CONTACT DETAILS Australian Q Fever Register Help Line 1300 QFEVER 1300 733 837 Postal Address Australian Q Fever Register PO Box 1278 Toowoomba QLD 4350 Phone 07 4688 2610 Fax number 07 4688 2699 Web site http www qfever org Q Fever and the Australian Q Fever Register Fact Sheet Page 4 of 4 Australian Q Fever Register Q Fever Release of Information Authority born Full name Date of birth of Full address believe have tick the correct situation been diagnosed with Q Fever by Dr in Doctor s name year participated in a Q Fever prescreening and vaccination program at Name of workplace where the program took place hereby consent to the release of my Q Fever results to the Q Fever program co ordinator as specified below 1 Results to be released E a copy of my pathology results from the Doctor or medical practice Or in the case of a prescreening and vaccination program L a copy of my Q Fever test results and vaccination date if vaccinated 2 Address contact details to send results to Q Fever program co ordinator at Full address Email or fax Signature Date Please contact the National Q Fever Register if you have any queries Phone 1300 QFEVER 733837 Or 07 4688 2610 Fax 07 4688 2699 Website www gfever org
43. retained by the medical practitioner as part of the patient s medical record 2 Ifthe testing and vaccination is organised by an employer eg a meat processor one copy should be retained by the employer and filed in the employee s medical record 3 Information from a signed Personal Details and Consent Form and the Pre Screening and Vaccination Form can be added to the Register over the Internet Once the information is entered both forms should be sent to the Register office 4 Organisations that do not have Registered Users or do not have internet access can just send the forms to the Register without entering information over the internet For more information contact the Australian Q Fever Register on www gfever org Email register Ogfever org Ph 1300 QFEVER 1300 733837 or 07 4688 2610 Fax 07 4688 2699 Australian A Fever Register Pre Screening 8 Vaccination Form Version 15 04 2015 Australian Admin Use Only Organisation Number Q Fever Register Australian Q Fever Register Application for Access to the Register The Australian Q Fever Register is owned by the Australian Meat Processor Corporation AMPC Its purpose is to assist organisations to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace To access the Register an Organisation must complete this application form sign
44. s The address is help Ogfever org The Australian Q Fever Register Help Line The Australian Q Fever Help Line provides assistance to users of the Register as well as providing Q Fever Register Numbers to individuals The Help Line operates during Eastern Australian standard business hours The number for the Help Line is 1300 QFEVER 1300 733 837 CONTACT DETAILS Australian Q Fever Register Help Line 1300 QFEVER 1300 733 837 Australian Q Fever Register Email User assistance help afever org Register information info gfever org Australian Q Fever Register Web site http www gfever org Postal Address Australian Q Fever Register PO Box 1278 Toowoomba QLD 4350 Fax number 07 4688 2699 Direct line if calling from a mobile 07 4688 2610 16 APPENDICES FORMS FOR DOWNLOAD Current versions of all forms and additional information can be obtained by visiting the Q Fever Register web site Appendix A Personal Details and Consent Form Appendix B Pre screening and Vaccination Protocol Appendix C Application for Access Appendix D User Registration Form Appendix E Register Fact Sheet Appendix F Information Release Authority 17 Australian Registered User Only Insert Q Fever Register Q Fever Number Register i i Australian A Fever Register PO Box 1278 Toowoomba QLD 4350 Personal Details and Consent Form The Australian Q Fever Register is owned by the Australian Meat Processor
45. se tick only one box that best describes your intended job Work in a meat processing plant Work with livestock or wildlife Contractor or visitor to a meat processing plant Other Name of employer or Industry Group Previous Screening Vaccination believe have previously been tested and or vaccinated for Q fever Screening location Approximate Date and or name of GP month and year understand that e Information on the Register will only be used to check if have been previously tested vaccinated or infected with Q fever e Nobody can access my personal details on the Register without my permission Please read the information on the back of this page for more details before signing this form have read and understand the information on this form and hereby consent to the inclusion of my personal details and information relating to my Q Fever immune status in the Australian Q Fever Register Signed Date A Q FEVER CARD CAN NOT BE ISSUED UNLESS THIS FORM IS FULLY COMPLETED AND SIGNED Do Not send the information page page 2 of this document to the Register It is for you to read Australian Q Fever Register Personal Details and Consent Form Version 15 04 2015 Page 1 of 2 Information page for Personal Details and Consent form do not send this page to the Register understand that 1 The information that may be included on the register is Name
46. t is approved the researcher may be given access to the information Normally no identifying information name or address will be released Q Fever and the Australian Q Fever Register Fact Sheet Page 3 of 4 How can the information be used Your own information can only be used by you or with your permission your employer or doctor to find out your Q fever immune status A summary of the information in the Register is used for general reporting but contains no information that allows individuals to be identified This summary may contain for example the number of people diagnosed with Q fever the number vaccinated the percent of positive test results and so on What is the Q Fever Card When your details are entered into the Register or new information is added a Q Fever Register Card will be mailed to you This card contains your name your current Q fever immune status and your Q Fever Register Number This card should be kept and used to prove your immune status in the future What can you do if you forget your Q Fever Register Number You may be asked by your employers or doctors for your Q Fever Register Number They will need your number to be able to check the Register to see if you are immune to Q fever If you lose the card or need the Register Number and don t have the card with you telephone the Q Fever Register Help Line 1300 QFEVER 1300 733837 Register staff will ask you to identify yourself by asking your na
47. t the privacy rights of individuals whose data is on the Register e Protect the privacy rights of organisations seeking access to the Register When the Application is received and approved it gives the organisation the right to access the Register However an organisation must also nominate one or more individuals within the organisation to use the Register on behalf of the organisation The Application for Access to the Register should therefore be accompanied by one or more User Registration forms as described below Registering a User An organisation must nominate one or more Users who will access the Register For a meat processor a User will normally be a person who is responsible for occupational health and safety at the site eg an OH amp S nurse In a medical practice a User may be a doctor nurse or administrative staff An organisation may nominate more than one User so that when one person is not present another will still be able to access the Register However except at large sites there should be no more than two or three Users Each of the individuals within an organisation nominated as a User must complete a User Registration form This form includes a Secret Question and Answer Select one of the questions and write the answer in the space provided This will be used to identify the user during telephone queries If the site has Internet access the User should request a username to be used when logging on to
48. ter under the following conditions 7 1 Access to information on an individual is only permitted with the consent of that individual 7 2 Consent to access information shall be considered to have been granted if the individual informs the Organisation of their Q Fever Register Number full name and date of birth 7 3 The Organisation shall not keep records of the Q Fever Register Numbers of individuals nor reveal these numbers to any other individual or Organisation 7 4 The Organisation shall ensure that any information on an individual that has been obtained from the Register is not available to third parties 8 Use of Data The Organisation shall ensure that data collected from an individual or obtained from the Register is used only for the purpose for which it was obtained that is to determine the Q Fever immune status of an individual to prevent unnecessary testing and to minimise the risk of exposing susceptible individuals to the organism in the workplace 9 Research Information on the Register may be used for Research into Q Fever under the following conditions 9 1 Applications for use of Register data for research must be made to the Australian Q Fever Register Technical Management Committee made up of industry union occupational health and safety and medical representatives If approved the request will then be evaluated by an appropriate Ethics Committee 9 2 No individually identifying data will be released unless the ind
49. the form What information is kept There are two types of information on the Register information which identifies you and information about your immune status The identification information is e your gender male or female your first name middle names and surname e your date of birth e your current address and e a secret question and answer This is a question that only you are likely to know the answer to and helps Register staff confirm your identity if you ever need to make telephone inquiries The immune status information is e Date of any vaccination you have had e Date of any screening test you have had the test type and your test result e Date of any tests to confirm a diagnosis of Q fever you have had Does anybody else have access to this information Your personal information will not be released or sold for any commercial or marketing purpose No information will be released to any government authorities except in the following circumstances e where a government authority acts as a registered screening and vaccination service provider e where there are reasonable grounds to believe that disclosure is necessary to prevent a threat to life or health or e where required or authorised by or under law The Register may receive requests to use the information for research into Q fever Any requests will be considered by the Q Fever Technical Management Committee and an appropriate Ethics committee If the reques
50. to or access information from the Register 6 If I wish to know what details are recorded in the Register my Register Number to request a replacement Q Fever card or correct errors in the Register may call the Q Fever Register Help Line and identify myself using my name date of birth and answering the Security Question selected on this form must supply appropriate documentation in order to make any changes or corrections to the Register data 7 A copy of my Q Fever screening test results and Q Fever vaccination certificates will be sent to the Register and kept securely No unauthorised person will have access to these documents 8 Imay request for my details to be permanently removed from the Register at any time by ringing the Register Help Line 9 Summary information including the total number of people in the Register that have been tested vaccinated or diagnosed may be released publicly for the purpose of monitoring the disease but such information will not contain the names or details of individual persons 10 Information in the Register may be used for the purpose of research into Q fever subject to clearance by an Ethics Committee Researchers may then be provided with personal information allowing them to contact me for further information if have indicated on the form that consent to being contacted for research purposes Researchers may not disclose personal identifying information without my consent 11 My personal
51. to the Australian Q Fever Register Technical Committee They may at their discretion take any action required to correct the problem Actions may include but may not necessarily be limited to requiring a guarantee that the cause of the breach has been remedied and that similar future breaches will not occur temporary or permanent removal of access rights to the Register or in the case of severe breaches recommending appropriate legal action be taken For more information contact the Q Fever Register Help Line or visit the Q Fever Register Web site Australian Q Fever Register Help Line 1300 QFEVER 1300 733 837 Or 07 4688 2610 Fax number 07 4688 2699 Australian Q Fever Register Web site http www qfever org Postal Address Australian Q Fever Register PO Box 1278 Toowoomba QLD 4350 Australian Q Fever Register User Registration Form Page 3 of 3 Australian Fact Sheet Q Fever Register Q Fever and the Australian Q Fever Register The Bare Facts Q Fever e Q fever is an infectious disease that can cause severe illness in some people e People usually get Q fever from animals such as goats cattle and sheep e People who work with or near animals are most at risk of getting Q fever e Everyone at risk should have a test to see if they are protected from the disease Protection e You are probably protected from Q fever if o You have had a vaccination o You have had a test which says you are protected o
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