Forms for Health Professionals
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Communicable Disease (Including Food Poisoning, Animal Bite Exposure and STIs)
Specific Diseases
- Report an Animal Bite Exposure
- Chickenpox (Varicella) Reporting Form
- Hepatitis B Hospital Neonate Reporting Form
- Report an Infection From a Tattoo, Piercing, Manicure or Pedicure
- STI Medication Order Form
- Tuberculosis
More Information
Immunization and Vaccines
Publicly Funded Vaccines and Supplies
- Requisition for Biological Supplies (OGPMSS)
Vaccines for High-Risk Groups
Note: Please read the eligibility criteria before ordering online.
Reporting Forms
- Reporting a Cold Chain Incident and related forms
- Power Outage and Vaccine Storage
- Returning Expired or Spoiled Vaccines
- Vaccine cold chain maintenance and inspection report
- AEFI Reporting Form (Public Health Ontario). Fax the completed form to 416-338-2028. Note: If the form doesn’t open from the link above, download it using the download icon on the top right of the page. Use Adobe’s free Acrobat Reader software to complete and save the fillable form.
Preschool Speech and Language Program
Preschool Speech and Language Program
Financial Reporting
- Settlement Certification and Auditor’s Statement Template
- Settlement Form Template
- Quarterly Financial Report Template
Program Delivery and Reporting
Blind-Low Vision Early Intervention Program
Referral
Financial Reporting
- Settlement Certification and Auditor’s Statement Template
- Settlement Form Template
- Quarterly Financial Report Template
Program Delivery and Reporting
Infant Hearing Program
Referral
Audiology
Financial Reporting
- Audiology Monthly Invoice Summary
- Audiology Cost Tracking Form
- Appointment Types/Fee Schedule/Invoicing Requirements
Program Delivery Reporting
Communication Development
Financial Reporting
Program Delivery Reporting
Screening
Financial Reporting
Program Delivery and Reporting
Outbreak Management for Institutions
Long-Term Care and Retirement Homes
Respiratory
- Initial Respiratory Outbreak Notification Form
- Respiratory Outbreak Line List
- Respiratory Hospitalizations and Deaths Line List Form
- Outbreak Transfer Notification
- Respiratory Outbreak Management Team Meeting Checklist
Enteric
- Initial Enteric Outbreak Notification Form
- Enteric Outbreak Line List
- Enteric Hospitalizations and Deaths Line List Form
- Outbreak Transfer Notification
Acute Care and Complex Continuing Care Facilities
Respiratory
- Initial Respiratory Outbreak Form
- Outbreak Notification Sign
- Instructions for Collecting a Nasopharyngeal Swab
- Respiratory Outbreak Summary and Epi-Curve
- Community Care Access Centre (CCAC) Outbreak Notification Form
- Respiratory Outbreak Transfer Notification Form
- Respiratory Outbreak Management Team Meeting Checklist
Enteric
- Public Health Laboratory – Outbreak Notification Report Form
- Initial Enteric Outbreak Notification Form
- Enteric Outbreak Line List
- Enteric Hospitalizations and Deaths Line List form
- Outbreak Notification Sign
- Enteric Outbreak Transfer Notification Form
C-difficile
- Clostridium Difficile Outbreak Line List
- Clostridium Difficile Outbreak Epi Curve
- Clostridium Difficile Outbreak Checklist