Forms for Health Professionals

Communicable Disease (Including Food Poisoning, Animal Bite Exposure and STIs)

• Communicable Disease, including STIs and Food Poisoning Reporting Form (all diseases, excluding COVID-19)

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
  • Notification of Latent TB Infection and Medication Order Form
  • Notification of Active TB Disease Reporting Form

More Information

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

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 416-696-3492.
  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.

Outbreak Management for Institutions

Long-Term Care and Retirement Homes

Access forms for:

• Respiratory
• Enteric
• COVID-19

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

More Information

More Information on Enteric and Respiratory Outbreaks

Laboratory

• Public Health Laboratories requisitions and specimen collection guide, OAHPP