Health Forms
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This collection comprises of NT Health forms that have been made available to the public. Please note that this collection will soon be phased out as forms are moved to the main NT Health website.
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Technical Report Biting insect survey and assessment, Blacktip Project, supplementary trapping, September 2004(Medical Entomology, DHCS, 2005-03-10) ;Warchot AWhelan PIAs part of the biting insect assessment for the Blacktip Project, traps were required to be set during the peak pest biting midge season months of either August, September, October or November. The month of September was to sample peak season numbers of the main human pest biting midge in coastal areas of Northern Australia, Culicoides ornatus. Peak abundance of C. ornatus occurs around the time of the full moon each month, with numbers generally elevated over a four-five day period. Numbers of C. ornatus can vary dramatically over this four-five day period, although previous studies have shown highest numbers generally occur one day before the full moon and on the day of the full moon. To define the peak numbers of C. ornatus in September, trapping was proposed to occur over a three day period around the full moon, which was to include trapping one night before the full moon, the night of the full moon, and the night after the full moon. This trapping was also likely to indicate peak mosquito numbers for this month, with the exception of Ochlerotatus vigilax, which generally occur 10 days after the monthly high tide. The ensuing report discusses the new findings and recommendations derived from the September 2004 trapping period, and is to be used as a supplement to the Biting Insect Survey and Assessment report for the Blacktip Project, which was produced in July 2004. The new findings provided in this report can supersede the equivalent findings in the July 2004 report.3290 278 - Publication
Form Application Form Police Check Volatile Substance Abuse Prevention(Department of Health, 2006)Department of Health1957 392 - Publication
Information Sheet Radiation protection code of practice : acquiring a radiation source(Department of Health, 2011-10)Department of HealthThis code of practice is read with the code of practice for disposal of a radiation source.3197 1140 - Publication
Form Application for Waiver or Reduction of Fees(Department of Health, 2012) ;Information and PrivacyDepartment of HealthApplication for waiver or reduction of fees3297 914 - Publication
Guideline Pharmacy Premises Committee of the Northern Territory complaint guide and form(2012)Department of Health1199 481 - Publication
Report Alcohol Mandatory Treatment quarterly report October – December 2013(Department of Health, 2013) ;Department of HealthAlcohol and Other Drugs4410 155 - Publication
Form Pre-vaccination checklist(Department of Health, 2013-07) ;Department of HealthCentre for Disease Control2025 982 - Publication
Form Appendix A : Notification of supply of an unrestricted schedule 8 substance(Department of Health, 2014)Department of Health8336 2414 - Publication
Form Contract for Patients Prescribed Opiate Pharmacotherapy(Department of Health, 2014)Department of Health3178 1329 - Publication
Form Appendix B - Application for Authority to Prescribe a Restricted S8 Psychostimulant Medication(Department of Health, 2014)Department of Health10817 5495 - Publication
Form 1748 569 - Publication
Contract 1567 1356 - Publication
Form Disability Equipment Program : Application Form – Part A - D(Department of Health, 2014-03)Department of HealthThis document outlines eligibility, assistance which is provided when applying for equipment. The application must be filled in entirely (Parts A to E as required) before being submitted.1835 1100 - Publication
Form Register of all receipts and use of schedule 7 substances : Regulation 49(Department of Health, 2014-04) ;Therapeutic GoodsDepartment of HealthA register for users of poisons1835 473 - Publication
Form Freedom of Information : Application to Correct Information Form(Department of Health, 2015) ;Department of HealthLegal Services2629 411 - Publication
Technical Report Mosquito investigation Wagait Beach 14th to 15th January 2015(Medical Entomology, DoH, 2015-07)Warchot, AllanMedical Entomology received a mosquito enquiry from Wagait Shire Council on the 9th of January 2015. The complaint was received around the time of high salt marsh mosquito (Aedes vigilax) numbers in the Darwin Northern Suburbs, and when other areas of the Top End coastline were most likely also experiencing similar mosquito problems. Aedes vigilax has a very long flight range, and thus during major early wet season rainfall events, much of the NT coastline is likely to experience seasonal problems. However, in light of a lack of recent mosquito data from Wagait Beach, a mosquito investigation was carried out on the 14th-15th of January 2015, to determine which mosquito species was the causing the problem, the levels of mosquitoes compared to the most affected suburbs in Darwin, and the likely sources of the problem mosquitoes.2473 809 - Publication
Form Possess Scheduled Medicines in a Medical Kit Application Form(Department of Health, 2016)Medicines & Poisons Control4062 1231 - Publication
Report Ultrasound for remote area midwives : expression of interest to attend(Department of Health, 2016) ;Department of HealthNursing and Midwifery Branch3538 328 - Publication
Form Childbirth Education Enrolment Form(Department of Health, 2016) ;Department of HealthNursing & Midwifery1819 483 - Publication
Working Paper Pharmacy Premises Committee of the Northern Territory forms(Deparment of Health, 2016)Department of Health3016 1951