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 fax to your nearest Community and Public Health Office.
Canterbury Notification Forms
- Canterbury Measles Notification Form [227KB]
- Canterbury Pertussis Notification Form [114KB]
- Canterbury Notice of Notifiable Disease (Non-Identified Basis) Form – including STIs [KB]
- Canterbury Notifiable Diseases Notification Form for general practice [89KB]
- Canterbury Notifiable Diseases Notification Form for hospitals [162KB]
South Canterbury Notification Forms
- South Canterbury Measles Notification Form [112KB]
- South Canterbury Notifiable Diseases Notification Form [39KB] – for general practice and hospitals
West Coast Notification Forms
- West Coast Measles Notification Form [227KB]
- West Coast Pertussis Notification Form [115KB]
- West Coast Notice of Notifiable Disease (Non-Identified Basis) Form – including STIs [KB]
- West Coast Notifiable Diseases Notification Form for general practice [89KB]
- West Coast Notifiable Diseases Notification Form for hospitals [KB]
Outbreak Notification and Case Log Forms
- Early Childhood Centre Outbreak Notification Form [61KB]
- School Outbreak Notification Form [63KB]
- Hospital Outbreak Notification Form [49KB]
- Rest Home Outbreak Notification Form [49KB]
- Outbreak Case Log Form [47KB]
Contact the Communicable Disease staff at your local office for further information:
CANTERBURY
Ph: +64 3 364 1777
Fax: +64 3 379 6484
SOUTH CANTERBURY
Ph: +64 3 687 2600
Fax: +64 3 688 6091
WEST COAST
Ph: +64 3 768 1160
Fax: +64 3 768 1169
- 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
- We’re updating our ways of sending information to you
- Measles outbreaks are now centred on Auckland
- Sporadic rheumatic fever cases continue in the South
- Canterbury Wellbeing Index: Explore your community’s health and wellbeing
Latest public health alerts
- Measles outbreaks overseas - 28th February 2019
- Measles Alert - 26th February 2019
- Measles Alert - 22nd February 2019
Featured links
- Cantabrians urged to protect themselves against Legionnaires’ disease
- New measles case confirmed in South Canterbury
- Information on current measles outbreak (Ministry of Health)
Helpful links
Page last updated: 20/09/2019