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: These forms will be progressively updated with the phase-out of faxes.
Canterbury Notification Forms
- Canterbury COVID-19 Notification Form [132KB] – updated February 2022.
- Canterbury Measles Notification Form [181KB] – updated September 2021.
- Canterbury Pertussis Notification Form [163KB] – updated September 2021.
- Canterbury Notice of Notifiable Disease (Non-Identified Basis) Form – including STIs.
- Canterbury Notifiable Diseases Notification Form for general practice [62KB] – updated April 2022.
- Canterbury Notifiable Diseases Notification Form for hospitals [64KB] – updated April 2022.
- Canterbury Hazardous Substances Disease and Injury Reporting Case Form [75KB] – for general practice.
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.
- West Coast Notifiable Diseases Notification Form for general practice [89KB].
- West Coast Notifiable Diseases Notification Form for hospitals.
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
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
- Interim clinical guidance on testing for possible COVID-19 reinfection
- Information on monkeypox from the Ministry of Health
- Restart of respiratory reports
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
- Monkeypox to become a notifiable disease (Beehive)
- Information on COVID-19 from the Ministry of Health
- Information on RSV (Ministry of Health)
Helpful links
Page last updated: 16/06/2022