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 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

• Paediatric Speech and Language Screening Tool

Financial Reporting

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

Program Delivery and Reporting

• Geographic Service Areas
• PSL Data Tracking Manual
• Early Abilities Client Tracking Form
• PSL Outcome Measurement Guide
• Outcome Measures Record Form

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 2019-20

Referral

• Infant Hearing Program (IHP) Intake Form

Audiology

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 2019-20

Program Delivery Reporting

• Standardized Test Results Outcome Measures Form
• Coordinated Family Services Plan

Screening

Financial Reporting

• Screening Invoice Monthly Summary and Fee Schedule

Program Delivery and Reporting

• Equipment Repair Protocols
• Screening Cost and Tracking Form
• Infant Hearing Program (IHP) Screening Documentation Instruction

Enteric Outbreak Management

• Outbreak Notification Sign
• Enteric Outbreak Transfer Notification Form
• Public Health Laboratory – Outbreak Notification Report
• Enteric Outbreak Line List
• Enteric Hospitalizations and Deaths Line List form

Respiratory Outbreak Management

• Initial Respiratory Outbreak 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