HCP Forms

This form is to be used to report MPox (Monkeypox) in the community.

Read more about MPox (Monkeypox) Reporting Form

Gonorrhea and Chlamydia Co-Infection HCP Reporting Form

Read more about Gonorrhea and Chlamydia Co-Infection HCP Reporting Form

Enteric/Food-Borne Diseases Reporting Form

Read more about Enteric/Food-Borne Diseases Reporting Form

Vaccine Return Form

Read more about Vaccine Return Form

COVID-19 Investigation and Reporting Form

Read more about COVID-19 Investigation and Reporting Form

West Nile Virus Case Investigation Tool

The Health Protection and Promotion Act 1990 (HPPA) outlines the requirements for physicians, practitioners, and institutions to report any suspect or confirmed reportable disease to the Medical Officer of Health. This information is collected under Regulation 569, 2005. Please complete this form and fax to the Windsor-Essex County Health Unit, Fax: 226 783-2132. If you have any questions or concerns, call 519-258-2146, ext.1420.

Read more about West Nile Virus Case Investigation Tool

Rubella Health Care Provider Investigation and Reporting Form

If rubella is suspected or diagnosed, completion of this form is required and faxed by the next working day from the initial patient visit, to the Windsor-Essex County Health Unit (fax: 226-783-2132.

Read more about Rubella Health Care Provider Investigation and Reporting Form

Hepatitis B HCP Reporting Form

Rabies Investigation Form - FOR HOSPITAL USE ONLY

Vaccine Order Form

MPox (Monkeypox) Reporting Form

Gonorrhea and Chlamydia Co-Infection HCP Reporting Form

Enteric/Food-Borne Diseases Reporting Form

Vaccine Return Form

COVID-19 Investigation and Reporting Form

West Nile Virus Case Investigation Tool

Rubella Health Care Provider Investigation and Reporting Form

Organization

Resources

Privacy Policy

Offices

Site Map