Emerging respiratory pathogens and Severe Acute Respiratory Infection (SARI) case report form

Version 0.8 (Last updated June 19, 2015)

Instructions for completion

• Please complete as much detail as possible on this form at the time of the initial report
• It is not expected that all fields will be completed during the initial report, but that updates will be made when information becomes available

Instructions to local public health authorities

• Reporting: Please report cases using normal local / provincial/territorial methods

Instructions to provincial / territorial public health authorities

• Reporting: Fax completed form (without first page) to 1-800-332-5584 and send an email notification (do not attach form) to HSFLUEPI@phac-aspc.gc.ca, within 24 hours of case notification to Provincial/Territorial Public Health
• After regular business hours (8:00 – 5:00pm ET) please contact the Health Portfolio Operations Centre at 1-800-545-7661 or phac-aspc.hpoc-cops@canada.ca