Forms for Health Care Professionals
Need some help with our online forms?
Watch our “How to” video guide below to learn how to submit temperature logs and vaccine orders using our hassle-free online forms to save time.
Order Forms
• Harm Reduction Supply Order Form
• Resource Order Form
• Vaccine Order Form
• Vaccine Return Form
• Vaccine Temperature Logs
• 2024-2025 Flu Season OPT-IN
To order vaccines through fax or email, please email vaccineorders@county-lambton.on.ca to receive a fillable form.
Reporting Forms
• Animal Exposure Reporting Form
• AEFI Reporting Form
• Bacterial STBBI Infection Treatment Form
• Cold Chain Incident Form – Report by phone 519-383-8331
• Facility Outbreak Line List (pdf)
• Report Measles (pdf)
• Reportable Diseases
• Tick Identification Form
• Tuberculosis Reporting Form (pdf)
• Vaccine Temperature Logs
• Sexual Health Reporting – Chlamydia and/or Gonorrhea Reporting Form (pdf), Syphilis Reporting Form (pdf), Report Hepatitis B/Hepatitis C/HIV by phone 519-383-8331 extension 3547 or fax 519-383-6310 (during business hours only).
• Vaccine Temperature Logs
Reporting outbreaks
To report a suspect or confirmed outbreak to LPH, please call 519-383-8331 ext. 3537 from 8:30 am to 4:30 pm Monday to Friday and 519-383-8331 after hours and on weekends and holidays.
Referral Forms
• Community Paramedic Referral Form
• LPH Family Health Program Referral Form
The Family Health Program Referral form is for Prenatal Health, Prenatal Classes, Healthy Babies Healthy Children (HBHC) Program, Growth and Development, Infant Feeding and Nutrition, Maternal Mental Health, Food Security, Speech and Language, Social Supports, Oral Health (for children ages 17 and under), Parenting, Other.