Animal Bite / Rabies Investigation Form (NEW - November 2024)

Communicable Disease Report Form (NEW - June 2024)

Infectious Diseases

• Emerging respiratory pathogens and Severe Acute Respiratory Infection (SARI) case report form (PHAC)
• Viral Respiratory Illness Hospital Admission Or Death Reporting Form (October 2023)
• NWT Measles Case Investigation Form (December 2023)
  • NWT Measles Case and Contact Linelist (Excel) (February 2024)
• NWT Poliomyelitis Investigation Reporting Form (September 2023)
• Pertussis Investigation Form (December 2023)
• Pertussis Contact List (January 2020) 

Immunizations

• Vaccination Administration Report Form (Only for those not on EMR)(January 2023)

Sexually Transmitted Infections

• Hepatitis B and C Case Investigation Form (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 (December 2023)

Tuberculosis

• NWT Bacille Calmette-Guérin (BCG) Vaccine Consent Form 
• TB Assessment Form (UPDATED - July 2024)
  • OCPHO TB Case Progress Report Form (Only for follow-up after TB Assessment Form sent in) (NEW July 2024)
• Tuberculin Skin Test (TST) Report Form (April 2023)
• TB Investigation Contact Tracing Form (UPDATED - July 2024)