hselogo hpsclogo Slogan
  • RSS
  • Data Privacy
  • Cookie Policy
  • +353 1 8765300
  • Home
  • Menu
  • Notifiable Diseases
  • Publications
  • EPI-Insight
  • Topics A-Z
  • COVID-19 (Novel Coronavirus)
COVID-19 Information
  • Home
  • Notifiable Diseases
  • Notification Forms

Notification Forms

Notification Form

This is the form to be used by a medical practitioner when notifying an infectious disease to a Medical Officer of Health. This is a writable form.

Infectious disease outbreak reporting form

File Size: (861kB)

Core dataset for Sexually Transmitted Infections (STIs) notification by clinicans

File Size: (95kB)
Publication Date: 9th July 2014

Enhanced Surveillance and Investigative Forms

These surveillance forms are for use by Health Care Professionals and relate to specific infectious diseases where enhanced surveillance is undertaken.

  • Acute Flaccid Paralysis (AFP)
  • Avian Influenza
  • Bacterial Meningitis / Meningococcal Disease
  • Chickenpox (Varicella)
  • COVID-19
  • Cryptosporidiosis
  • EARSS Enhanced Bacteraemia Surveillance
  • Gastroenteritis
  • Gonorrhoea
  • Haemophilus influenzae
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis E
  • HIV
  • Humanitarian Aid Workers going to VHF-affected areas
  • Infectious intestinal disease (IID)
  • Influenza
  • Legionellosis
  • Leptospirosis
  • Listeriosis
  • Lymphogranuloma Venereum
  • Malaria
  • Measles
  • Mumps 
  • Outbreaks
  • Pertussis
  • Plague
  • Pneumococcal Disease (invasive)
  • Rubella
  • Salmonellosis
  • Shigella
  • Streptococcus group A (invasive)
  • Syphilis
  • Tetanus
  • Tuberculosis
  • Varicella (Chickenpox)
  • Verotoxigenic Escherichia coli (VTEC)
  • Zika virus infection

Last updated: 4 March 2021

Notifiable Diseases

  • Notifying Infectious Diseases
  • List of Notifiable Diseases
  • Who to notify
  • How we handle your data
  • What is disease surveillance
  • Case Definitions
  • Notification Forms
  • Annual ID Statistics
  • Annual Epidemiological Reports
  • Weekly ID Reports
  • Resources

Find a Topic


Topics A - Z

Publications

  • COVID-19 Cases in Ireland- Infographic prepared by HPSC on 16/04/2021 17 April 2021
  • 14-day Epidemiology report of COVID-19 in Ireland - Report prepared by HPSC on 16/04/2021
  • COVID-19 Robot surveillance weekly report 15/04/2021 16 April 2021
  • Approach to risk assessment of visits to private homes or similar setting by a resident from a long term residential care facility (LTRCF) 16 April 2021

News

  • COVID-19: Cases in Ireland reports, infographic and COVID-19 data hub 29 March 2021
  • IPC and AMR eLearning foundation programme 16 March 2021
  • HPSC successfully retained ISO27001 Information Security certification 5 March 2021
  • An additional 18 countries subject to restrictions upon travel to the State from certain States 12 February 2021

25-27 Middle Gardiner St, Dublin 1 Ireland. t: +353 1 8765300 f: +353 1 8561299
 

© Health Protection Surveillance Centre 2011-2020

wai
Cookie Settings