Animal Bite / Rabies Investigation Form

Communicable Disease Passenger Declaration Form

Communicable Disease Report Form

Food and Waterborne Illness Investigation Form

Passive Surveillance for Blacklegged ticks (Public Health Agency of Canada)

Sexually Transmitted Infections

• Hepatitis B and C Case Investigation Form
• NWT STI Case Investigation Report Form (UPDATED August 2019)
• NWT STI Contact Tracing Form (Updated August 2019)

Infectious Diseases

• COVID-19 Reporting Forms
• HIV Case Investigation Form
• NWT Confirmed Influenza Reporting Form (NEW - October 2019)
• NWT Measles Case Investigation Form
• Meningitis Investigation Form
• MRSA Investigation Form
• NWT RSV Prophylaxis Risk Assessment and Order Form
• Pertussis Investigation Form (NEW - January 2020)
• Pertussis Contact List (NEW - January 2020)
  • Pertussis Contact List (PDF)
  • Pertussis Contact List (Excel)

Tuberculosis

• TB Assessment Form
• Active TB Drug Treatment and Progress Record
• Latent Tuberculosis Infection (LTBI) Treatment Initiation Form
• Latent Tuberculosis Infection (LTBI) Treatment Completion Form
• Latent Tuberculosis Infection (LTBI) Drug Treatment & Progress Record
• LTBI Tuberculosis Surveillance
• Tuberculosis Case and Contact Tracing Record
• Tuberculosis Surveillance & Screening