This form is for the notification of COVID-19 by medical practitioners to the Victorian Department of Health & Human Services, as scheduled by the Public Health and Wellbeing Regulations 2019. This form should take 3-5 minutes to complete and you should retain a copy for your records.
Further information on COVID-19 can be found at the department's website: https://www.dhhs.vic.gov.au/novelcoronavirus
Please ensure that the case has been informed of the following:
•their diagnosis,•that you are providing this information to the department (as required by the Health Records Act 2001), and•that the department may contact them for further information about their illness.
Commonwealth and State privacy legislation does not negate the responsibility to notify the specified conditions or to provide the information requested on this form.