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Report Infectious Disease

Personal information on this form is collected under the authority of the Health Protection and Promotion Act, Sections 22 and 24, and will be used for Public Health follow-up. Any questions should be directed to the Infectious Disease Program at 519-575-4400 x5275.

Are you a Health Care Worker?

Yes

City of Cambridge

City of Kitchener

City of Waterloo

Township of North Dumfries

Township of Wellesley

Township of Wilmot

Township of Woolwich