The Middlesex-London Health Unit is currently under a province-wide Stay-At-Home Order
COVID-19 Info | Information sur la COVID-19 | COVID-19 Self-Assessment | COVID-19 Lab Results

Middlesex-London Health Unit

🔍Search
🔍
Home
Inner Nav

Forms for Healthcare Providers

The Middlesex-London Health Unit offers a variety of forms in an effort to simplify connections between the Health Unit and local healthcare providers. Please find the forms below.

 

Contact Us

To order forms from the Health Unit, please contact us.

healthcareproviders@mlhu.on.ca
519-663-5317

 

Referral Forms

Child Development/Parenting/Prenatal Health/Post-partum
*Please save the PDF to your computer before filling out the form.


Reporting Forms

Environmental Health

Immunization

Infectious Diseases

Substance Use


Order Forms

Immunization

Infectious Diseases


Submission Forms


Consent Forms

Immunization

 
Date of creation: September 23, 2016
Last modified on: April 8, 2021