Notify public health of new active leprosy without retyping patient identifiers

Physicians and laboratories reporting suspected or confirmed new active leprosy cases to the medical officer of health repeat patient name, contact details, and clinical identifiers on Form 3. This guide is an example of storing them once in hivi.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Reports regulation (Reg. 569) — ontario.ca
• Form (Central Forms Repository): Form 3 — Notification of New Active Leprosy (Hansen's Disease) — 14-5054-64

What this form is about

Form 14-5054-64 is Form 3 — Notification of New Active – Leprosy (Hansen's Disease), the prescribed report under Ontario Regulation 569 for leprosy cases of public health significance.

Before you start: what to gather

• Patient full legal name and date of birth.
• Patient address and contact phone.
• Reporting physician or laboratory name and contact.
• Clinical and laboratory findings — confirm reporting timelines with your local public health unit.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your patient name, address, and reporter contact details in your hivi profile.
2. Keep documents ready. Upload supporting documents to hivi Files so you are not searching at form time.
3. Autofill the form. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
4. Review and submit yourself through the official channel.

Why do it in hivi

Related Ontario forms repeat the same personal details. Captured once in hivi — stored in Canada, with AI on its own servers — every form starts mostly complete.