Forms for Health Professionals

• Communicable Disease, including STIs and Food Poisoning Reporting Form (all diseases)

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
  • TB Drug Order, Positive Skin Test and IGRA Reporting Form
  • Notification of Active New or Previously Treated TB Case

More Information

• Reporting Tuberculosis
• Reporting an Enteric or Respiratory Outbreak at an Institution
• More Information on Report an Animal Bite Exposure

Publicly Funded Vaccines and Supplies

• Requisition for Biological Supplies (OGPMSS)

Vaccines for High-Risk Groups

Note: Please read the eligibility criteria before ordering.

• Order online (preferred method)
• Order using PDFs
  • Hospital Hepatitis B Vaccine Order Form for Neonates
  • Vaccine for High-Risk Individuals – Order Form Updated August 2017
  • Vaccine for High-Risk Individuals – Autoshipment Agreement Updated August 2017

Reporting Forms

• Report an Adverse Event Following Immunization Form (PHO)
• Menactra® Vaccine Reporting Form for High School Students
• 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

Referral

• Referral Form

Financial Reporting

• Settlement Certification and Auditor’s Statement Template
• Settlement Form Template
• Quarterly Financial Report Template

Program Delivery and Reporting

• Geographical Service Areas
• PSL Data Tracking Manual
• PSL Outcome Measurement Guide
• Outcome Measures Record Form

Ordering Print Material

Early Abilities Speech and Language Program Resources

• Communication Checklist
• Child Development
• Posters and Brochures

More Information

Preschool Speech and Language Program

Referral

• Vision/Eye Report Form 
• Blind-Low Vision Referral Form

Financial Reporting

• Settlement Certification and Auditor’s Statement Template
• Settlement Form Template
• Quarterly Financial Report Template

Program Delivery and Reporting

• Client Tracking Form
• Service Targets 2018-19

More Information

Blind-Low Vision Early Intervention Program

Referral

• Infant Hearing Program (IHP) Intake Form

Financial Reporting

• Audiology Monthly Invoice Summary
• Audiology Cost Tracking Form
• Appointment Types/Fee Schedule/Invoicing Requirements

Program Delivery Reporting

• Goals and Deliverables
• Equipment Repair Protocol
• Audiology Form – Ax/CI/HR Surveillance 

Communication Development

Financial Reporting

• Communication Invoicing and Client Tracking Form 2018-19

Program Delivery Reporting

• Standardized Test Results Outcome Measures Form
• Communication Progress Report Template

Screening

Financial Reporting

• Screening Invoice Monthly Summary and Fee Schedule

Program Delivery and Reporting

• Equipment Repair Protocols
• Screening Cost and Tracking Form
• Screening Form and Instructions

Order

• IHP Screening Supplies
• IHP Audiology Supplies

More Information

Infant Hearing Program

Enteric Outbreak Management

• Initial Enteric Outbreak Notification Form
• Enteric Outbreak Line List
• Hospitalizations, Complications & Deaths Chart
• Outbreak Notification Sign
• How to Collect a Stool Sample
• Enteric Outbreak Summary and Epi-Curve
• Community Care Access Centre (CCAC) Outbreak Notification Form
• Enteric Outbreak Transfer Notification Form

Respiratory Outbreak Management

• Initial Respiratory Outbreak Notification Form
• Respiratory Outbreak Line List
• Hospitalizations, Complications & Deaths of Line Listed Cases
• 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

More Information

More Information on Enteric and Respiratory Outbreaks

• Public Health Laboratories requisitions and specimen collection guide, OAHPP