Notifiable Disease Notification Forms
This page provides the forms for health professionals to inform Community and Public Health of a notifiable disease. Any information provided is strictly confidential and subject to the Privacy Act.
Download the appropriate form below to send to your nearest Community and Public Health Office.
Note: Most forms have been consolidated across all regions for 2023.
Notification Forms
- Measles Notification Form [117KB] – updated December 2022.
- Pertussis Notification Form [171KB] – updated December 2022.
- Notifiable Diseases Notification Form for general practice [125KB] – updated December 2022.
- Notifiable Diseases Notification Form for hospitals [108KB] – updated December 2022.
- Notice of Notifiable Disease (Non-Identified Basis) Form including STIs.
Outbreak Notification and Case Log Forms
- Aged Residential Care Outbreak Notification Form [52KB] – updated September 2023. Formerly known as Rest Home Outbreak Notification Form.
- Disease Illness Log Form for Aged Residential Care [60KB] – updated September 2023. Formerly known as Outbreak Case Log Form.
- Early Childhood Centre Outbreak Notification and Summary Form [54KB] – updated October 2023.
- School Outbreak Notification and Summary Form [54KB] – updated October 2023.
- Hospital Outbreak Notification and Summary Form [44KB] – updated December 2022.
Other forms
- Hazardous Substances Disease and Injury Reporting Case Form [110KB] – updated December 2022.
Contact the Communicable Disease staff at your local office for further information:
CANTERBURY
Ph: +64 3 364 1777
SOUTH CANTERBURY
Ph: +64 3 687 2600
WEST COAST
Ph: +64 3 768 1160
- Find out about Community and Public Health’s response to disease notifications.
- Find out about Community and Public Health’s response to gastroenteritis outbreaks in a hospital, education or elderly care setting.
Latest public health updates
- Protect yourself against Legionnaire's disease
- Information on typhoid fever from the Ministry of Health
- Find out about Intra Uterine Devices (IUDs) from Family Planning
Latest public health alerts
- Monkeypox is now a notifiable disease - 8th June 2022
- National Health Advisory: Monkeypox clinical update - 25th May 2022
- COVID-19 in “managed isolation and quarantine facility” staff - 5th November 2020
Featured links
- mpox no longer a public health emergency of international concern (World Health Organisation)
- WHO Chief declares end to COVID-19 as a global health emergency
- COVID-19 winter surge package 2022: Rapid review (Ministry of Health)
Helpful links
Page last updated: 11/10/2023