Reporting source
Identify the reporting source by ticking the appropriate box.

Name of reporting source
Enter the name and organisation of the reporting source.

Date
Enter the date that the disease was reported.

Contact phone
Enter a contact phone number for the reporting source.

Name of usual GP
Enter the first three letters of the GP’s name. A drop down box should appear. Either select the corresponding name from the drop down box or if the desired GP is unavailable, click the ‘new’ button and enter in a new GP and their details. After creating a new GP click the ‘save’ button.