Reporting Forms

• Chlamydia and Gonorrhea Reporting Form (pdf)
• Hepatitis B Reporting Form (pdf)
• Hepatitis C Reporting Form (pdf)
• Hepatitis C Specialist Reporting Form (pdf)
• Syphilis Reporting Form (pdf)
• HIV Reporting Form (pdf)
• Mandatory Blood Testing Act, 2006, c.26

Simcoe Muskoka District Health Unit provides publicly-funded STI medications to Health Care Providers (HCPs) in Simcoe Muskoka specifically for the treatment of Sexually Transmitted Infections (STI).

The following STI medications are available for distribution from the Ontario Government Pharmaceutical and Medical Supply Service (OGPMSS) and can be ordered through SMDHU:

1. Azithromycin

2. Benzathine penicillin G LA (Bicillin)

3. Cefixime

4. Ceftriaxone

5. Doxycycline

6. Erythromycin

7. Lidocaine

To ensure HCP’s are using these medications to treat only sexually transmitted infections, HCPs are required to report use through an aggregate reporting form.

Please complete and fax the forms below to order STI medications for your clinics.

• Ordering Form: STI Medication Program (pdf) – fax form to 705-721-7848.
• Reporting Form: STI Medication Program (pdf) – aggregate reporting form for STI medication use.
• Medication Return Form: STI Medication Program (pdf) – form for reporting disposal of expired STI medications.