Outbreak Reporting Form

This form is for reporting suspect or confirmed cases of gastrointestional or respiratory illnesses in high-risk settings, including long-term care homes, retirement homes, congregate living settings and shelters. The following form can be used for:

• Reporting symptomatic residents who are suspect cases of gastrointestinal, COVID-19 or other respiratory illnesses
• Reporting COVID-19 positive molecular test (PCR) or RAT results in residents
• Reporting results from Respiratory Virus testing in residents
• Reporting COVID-19 Virus and Respiratory Viruses or RAT results in staff ONLY when your facility is currently in a confirmed outbreak.
  • If you have multiple individuals to report, complete the Outbreak Activity Line List (OALL) and submit it through this web-reporting form.
  • If you do not already have a OALL, request one by emailing outbreak@regionofwaterloo.ca

Once submitted, you will receive an email confirmation. Region of Waterloo Public Health will follow up based on the level of priority. To report lab confirmed influenza call 519-575-4400 for the Service First Call Centre.

Submit this form daily BEFORE 1 p.m., even if waiting for further information or test results. This will ensure timely assessment and follow-up. Information received by the facility after 1 p.m. can be submitted to Public Health the following day.