Polio Australia encourages every polio survivor living in Australia (whether you contracted polio in Australia or overseas) to join the Australian Polio Register. Our strength lies in our numbers – please help us to get you the services you need by completing the form below.
You can also download a PDF version of the Australian Polio Register Form if you (or a family member / friend without internet access) would prefer to complete the form by hand and mail it to: Polio Australia, PO Box 500, East Kew Vic 3102.
Before completing the Australian Polio Register Form you can check this page to make sure that you haven’t previously submitted a Registration (note that an entry will only appear on that page if you have given Polio Australia permission to publish your polio details).
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If you strike a difficulty in submitting this form that you cannot resolve, you can download a PDF version of the Australian Polio Register Form to complete and mail to Polio Australia. You can also contact us by phone or email or advise our Webmaster of the difficulty you experienced.