Notification of Routine Condition

This form is used for the statutory required notification of conditions scheduled by the Public Health and Wellbeing Regulations 2019 to the Victorian Government Department of Health. Further information about notifying cases, printable forms and privacy fact sheets are available on the department's website.
The form should take 3-5 minutes to complete and you should retain a copy for your records.

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 nor to provide the information requested on this form.