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Confidential Surveillance of Carbapenemase producing Enterobacterales (CPE) Please return completed form within 24 hours of CPE confirmation to the VICTIMS Coordinating Center by faxing 03 9342 9355. For
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How to fill out surveillance and isolate referral

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How to fill out surveillance and isolate referral

01
Contact your healthcare provider or local public health department to request a surveillance and isolate referral form.
02
Fill out the form with accurate information about your symptoms, recent travel history, and potential exposure to COVID-19.
03
Submit the completed form to the designated agency for further evaluation and instructions on surveillance and isolation protocols.

Who needs surveillance and isolate referral?

01
Individuals who are experiencing COVID-19 symptoms and suspect they may have been exposed to the virus.
02
Individuals who have tested positive for COVID-19 and need to follow surveillance and isolation guidelines to prevent further spread of the virus.
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Surveillance and isolate referral is a process used to track and report individuals who have been exposed to a contagious disease and need to be isolated to prevent further spread.
Healthcare providers and public health officials are required to file surveillance and isolate referral.
Surveillance and isolate referral forms can be filled out electronically or manually, providing detailed information about the exposed individual.
The purpose of surveillance and isolate referral is to track individuals who have been exposed to contagious diseases and ensure they are properly isolated to prevent further spread.
Information such as the exposed individual's name, contact information, symptoms, date of exposure, and current health status must be reported on surveillance and isolate referral.
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