Vaccines and immunization

• 0-18 Report of Immunization form (PDF, 1 page, 102 KB)
• Report of Adverse Event Following Immunization (AEFI)
• Statement of Medical Exemption – Immunization of School Pupils Act
• Statement of Medical Exemption – Childcare and Early Years Act
• Vaccine Order Form (PDF, 1 page, 243 KB)
• Vaccine Return Form (PDF, 1 page, 439 KB)
• Vaccine Temperature Log Book (PDF, 26 pages, 3 MB)
• Thermometer Order Form (PDF, 1 page, 132 KB)
• 2025-26 Influenza and COVID-19 Vaccine Order Form (PDF, 1 page)
• 2025-26 RSV and RSV Prophylaxis Order Form (PDF, 1 page)

Infectious diseases

• Animal Exposure Report (PDF, 1 page, 168 KB)
• Rabies Vaccine & Immune Globulin: Patient Vaccination Schedule (PDF, 1 page, 70KB)
• Positive TB Skin Test (TST) IGRA Reporting Form (PDF, 1 page, 201 KB) Please note: this form can be submitted through OCEAN MD.
• Hepatitis B Vaccine HBIG Reporting Form for High-Risk Infants (PDF, 1 page, 176 KB)

Mandatory Blood Testing Act (MBTA)

Fax applications to our secure Reportable Diseases fax line: 1-855-WDG-LINE (1-855-934-5463).

• Mandatory Blood Testing Act, 2006 

Outbreaks

• Daily Outbreak Line Listing Fax Cover Sheet (PDF, 1 page, 104 KB)
• Enteric Outbreak Line Listing (PDF, 1 page, 140 KB)
• Respiratory Outbreak Line Listing (PDF, 1 page, 827 KB)
• Thermometer Order Form (PDF, 1 page, 132 KB)
• Vaccine Return Form (PDF, 1 page, 439 KB)

Sexually transmitted infections (STIs)

• Chlamydia Treatment Request for Information (PDF, 1 page, 101 KB)
• Gonorrhea Treatment Request for Information (PDF, 1 page, 101 KB)
• Coinfection Chlamydia and Gonorrhea Request for Information (PDF, 1 page, 198 KB)
• STI (Sexually Transmitted Infection) Medication Order Form (PDF, 1 page, 91 KB)
• STI (Sexually Transmitted Infection) Medication Log (PDF, 1 page, 76 KB)

Prenatal and parenting

• Prenatal referral form (PDF, 2 pages, 726 KB)

Oral Health

• Dental Outreach Referral Form (PDF, 3 pages, 245 KB)

Reproductive Health

• Referrals for contraception consultations, including IUD and Nexplanon insertions, can be made through OCEAN MD
  • Please note: All procedural contraception referrals require two appointments: an initial consultation appointment and a subsequent appointment for the insertion procedure. Also, any required prescriptions will be provided during that appointment. Please do not send clients with a prescription.