Form

Notifiable diseases: form for registered medical practitioners

Suspected case of reportable disease: form to notify the proper officer of local health protection team (HPT).

• From: UK Health Security Agency
• Published: 17 February 2010
• Last updated: 30 June 2016 — See all updates

Documents

Registered medical practitioner notification form (PDF version)

PDF, 17.8 KB, 1 page

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Registered medical practitioner notification form (Word version)

MS Word Document, 16.8 KB

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Complete this form to inform your local health protection team immediately about suspected notifiable disease cases.

Don’t wait for laboratory confirmation of the suspected infection or contamination before notification. Send the certificate to the proper officer within 3 days or phone them within 24 hours, if the case is urgent.

Published 17 February 2010
Last updated 30 June 2016 + show all updates

1. 30 June 2016

   Added Word version of registered medical practitioner notification form.

2. 17 February 2010

   First published.