Communicable Disease
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)
Infectious Diseases
- Respiratory Virus Severe Outcomes Surveillance Report Form (NEW - November 2022)
- NWT Measles Case Investigation Form
- Meningitis Investigation Form
- MRSA Investigation Form
- NWT RSV Prophylaxis Risk Assessment and Order Form
- Pertussis Investigation Form (January 2020)
- 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)(NEW - January 2023)
Sexually Transmitted Infections
- Hepatitis B and C Case Investigation Form
- NWT STI Case Investigation Report Form (UPDATED - November 2022)
- NWT STI Contact Tracing Form (UPDATED - November 2022)
- NWT Biolytical Inti HIV/Syphilis Multiplex Point-of-Care Test (POCT) Reporting Form (September 2022)
- Syphilis & HIV Lost-to-Follow-up Report Form
Tuberculosis
- NWT Bacille Calmette-Guérin (BCG) Vaccine Consent Form
- TB Assessment Form (NEW - April 2023)
- Tuberculin Skin Test (TST) Report Form (NEW - April 2023)
- TB Investigation Contact Tracing Form (NEW - April 2023)