Alberta Wait Times Reporting: Wait Time Trends4795Alberta Wait Times ReportingContact Government Services   | Ministries   | Government of Alberta Home Alberta.ca Health Alberta Wait Times Reporting Wait Time Trends Welcome to the Alberta Wait Times 0htmlFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js1616
Administrative Health Data15962March 20173/13/2017 3:29:00 PM3/13/2017 3:29:00 PM☐ Research (Research studies with approval from a research ethics board ☐ Information (Information to support planning, policy development, quality improvement projects Section 1: Application Details;Request Type ;Previous Request Information;Key Contact/Principal Investigator;Secondary Contact ;Section 2: Supporting Documentation;Research Requests;Information Requests;Section 3: Data Requested ;Cohort:0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Request for Acute Rheumatic Fever Medication Payment Coverage Form - May 2016295216/9/2016 8:41:00 PM6/9/2016 8:41:00 PMName: Last Enter Patient Last Name First Enter Patient First Name Date of Birth: Click here to enter a date Approximate cost of medication (per month): Enter approximate cost 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Carbapenemase Producing Organism Report295228/22/2016 3:10:00 PM8/22/2016 3:10:00 PMFax completed form to Alberta Health CD: 780-415-9609 Name Last Last Name First First Name Middle Middle Name SECTION 2: LABORATORY AND DISEASE DETAILS 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Enterovirus D68 Enhanced Surveillance Report2952411/23/2016 9:44:00 PM11/23/2016 9:44:00 PMFAX completed form to Alberta Health, CD: 780-415-9609 Date case investigation opened: Choose a date Date reported to Alberta Health: Choose a date 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Hantavirus Pulmonary Syndrome Enhanced Surveillance Report Hantavirus Pulmonary Syndrome295259/30/2016 7:54:00 PM9/30/2016 7:54:00 PMFax completed form to Alberta Health, CD: 780-415-9609 Date medical attention sought: Choose a Date If Yes, number of times hospitalized ☐ Disease contributed to death (secondary cause Birth Date: Choose a date;Gender: ☐ Male ☐ Female ☐ Other ☐ Unknown ;Municipality:      ;Other clinical comments:      ;Test Performed;Test Result;     ;     ;     ;     ;     ;     0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Hospitalized Seasonal Influenza Report2952710/1/2015 2:57:00 PM10/1/2015 2:57:00 PMFAX completed form to Alberta Health, CD: 780-415-9609 H1 H3 H5 H7 A(H1N1)pdm09 Date case investigation opened: Choose a date Date reported to Alberta Health: Choose a 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Alberta Outbreak Report Form (AORF)295301/5/2015 9:12:00 PM1/5/2015 9:12:00 PMEMAIL completed form to: cd.data@gov.ab.ca or Fax to: 780-415-9609 Date Investigation Opened: Choose a date Date Reported to Alberta Health: Choose a date Is this outbreak part of a 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Perinatally Acquired Notifiable Disease Enhanced Report295331/15/2016 5:21:00 PM1/15/2016 5:21:00 PMIf Yes, name of reserve: Enter Name Ethnic Group: ☐Caucasian ☐Black ☐Asian (East/SE) ☐Other Asian ☐Middle East/Arab ☐Latin American ☐First Nations ☐Inuit ☐Métis 0docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11
Post Exposure Prophylaxis Report Form34956211/8/2018 6:24:00 PM11/8/2018 6:24:00 PMSubmit form only when Alberta Health funded treatment and/or post exposure prophylaxis is provided Fax completed form to Alberta Health, CD: 780-415-9609 First Click or tap here to Submit form only when Alberta Health funded treatment and/or post exposure prophylaxis is provided.;Fax completed form to Alberta Health, CD: 780-415-96090docxFalse~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_Word.js11

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