Communicable Disease
Animal Bite / Rabies Investigation Form
Communicable Disease Report Form (NEW - December 2023)
Infectious Diseases
- Emerging respiratory pathogens and Severe Acute Respiratory Infection (SARI) case report form (PHAC)
- Viral Respiratory Illness Hospital Admission Or Death Reporting Form (NEW - October 2023)
- NWT Measles Case Investigation Form (UPDATED - December 2023)
- NWT Poliomyelitis Investigation Reporting Form (NEW - September 2023)
- NWT RSV Prophylaxis Risk Assessment and Order Form
- Pertussis Investigation Form (UPDATED - December 2023)
- Pertussis Contact List (January 2020)
- Preliminary Mpox Case Report Form (PHAC)
- Mpox Contact List (Excel) (September 2022)
Immunizations
- Vaccination Administration Report Form (Only for those not on EMR)(January 2023)
Sexually Transmitted Infections
- Hepatitis B and C Case Investigation Form (UPDATED - December 2023)
- NWT STI Case Investigation Report Form (November 2022)
- NWT STI Contact Tracing Form (November 2022)
- NWT Biolytical Insti HIV/Syphilis Multiplex Point-of-Care Test (POCT) Reporting Form (June 2023)
- Syphilis Lost-to-Follow-up Report Form (July 2023)
- Syphilitic Stillbirth Report Form (UPDATED - December 2023)
Tuberculosis
- NWT Bacille Calmette-Guérin (BCG) Vaccine Consent Form
- TB Assessment Form (April 2023)
- Tuberculin Skin Test (TST) Report Form (April 2023)
- TB Investigation Contact Tracing Form (April 2023)