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Other links
concerning Notifiable Conditions |
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Posters |
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Associated Programs |
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Notifiable Condition Reporting
Forms and Guidelines
for Local Health Departments
Standardized notifiable condition reporting forms and
guidelines for local public
health departments are now available for the following notifiable
conditions.
Additional forms for foodborne illnesses can be
found on the Disease of Foodborne
Origin page. For additional information on how to report a notifiable condition, please see
Report a Notifiable Condition.
|
Condition |
Reporting Forms
(revision date) |
Guidelines
(revision date) |
|
Animals Bites |
PDF |
01/2008 |
PDF |
06/2008 |
|
Anthrax |
PDF |
01/2008 |
PDF |
06/2008 |
|
Arboviral Disease |
PDF |
08/2009 |
PDF |
07/2008 |
|
Botulism, Foodborne |
PDF |
01/2008 |
PDF |
08/2008 |
|
Botulism, Infant |
PDF |
01/2008 |
PDF |
08/2008 |
|
Botulism, Wound |
PDF |
01/2008 |
PDF |
08/2008 |
|
Brucellosis |
PDF |
01/2008 |
PDF |
06/2009 |
|
Campylobacterosis |
PDF |
01/2008 |
PDF |
09/2007 |
|
Chancroid |
PDF |
01/2009 |
PDF |
06/2008 |
|
Chlamydia |
PDF |
01/2009 |
PDF |
06/2008 |
|
Cholera |
PDF |
01/2008 |
PDF |
01/2008 |
|
Creutzfeldt-Jakob disease (CJD) |
See "Prion
Diseases, Human" |
|
Cryptococcal Disease |
PDF |
02/2008 |
(none) |
|
Cryptosporidiosis |
PDF |
01/2008 |
PDF |
12/2008 |
|
Cyclosporiasis |
PDF |
01/2008 |
PDF |
03/2008 |
|
Diphtheria |
PDF |
01/2008 |
PDF |
12/2008 |
|
Enterohemorrhagic E. coli |
PDF |
01/2008 |
PDF |
10/2007 |
|
Foodborne Disease Outbreaks |
PDF
- Pt.1
PDF - Pt.2
PDF - Pt.3 |
08/2009 |
PDF |
07/2009 |
|
Giardiasis |
PDF |
01/2008 |
PDF |
12/2008 |
|
Gonorrhea |
PDF |
01/2009 |
PDF |
06/2008 |
|
Granuloma |
PDF |
01/2009 |
PDF |
06/2008 |
|
Gunshot |
PDF |
03/2006 |
HTM |
08/2007 |
|
Haemophilus Influenzae |
PDF |
01/2008 |
PDF |
12/2008 |
|
Hantavirus Pulmonary Syndrome |
PDF |
01/2008 |
PDF |
06/2009 |
|
Hemolytic
Uremic Syndrome (HUS) |
PDF |
01/2008 |
PDF |
10/2007 |
|
Hepatitis A,
acute |
PDF |
08/2008 |
PDF |
11/2009 |
|
Hepatitis B,
acute |
PDF |
08/2008 |
PDF |
01/2009 |
|
Hepatitis B,
perinatal |
PDF |
02/2008 |
(refer to
Hepatitis B) |
|
Hepatitis B
and C, chronic |
PDF |
02/2008 |
(refer to
Hepatitis B or C) |
|
Hepatitis C,
acute |
PDF |
08/2008 |
PDF |
12/2008 |
|
Hepatitis,
Unspecified |
PDF |
08/2008 |
PDF |
05/2008 |
|
Herpes, Genital |
PDF |
01/2009 |
PDF |
06/2008 |
|
HIV/AIDS |
PDF |
08/2007 |
PDF |
06/2008 |
|
Influenza |
PDF |
10/2009 |
(none)
|
|
Lead, Child Blood |
PDF |
09/2008 |
(none) |
|
Legionellosis |
PDF |
01/2008 |
PDF |
07/2008 |
|
Leptospirosis |
PDF |
01/2008 |
PDF |
07/2008 |
|
Listeriosis |
PDF |
01/2008 |
PDF |
10/2007 |
|
Lyme Disease |
PDF |
01/2008 |
PDF |
02/2008 |
|
Lymphogranuloma |
PDF |
01/2009 |
PDF |
06/2008 |
|
Malaria |
PDF |
01/2008 |
PDF |
02/2010 |
|
Measles |
PDF |
01/2009 |
PDF |
12/2008 |
|
Meningococcal Disease |
PDF |
01/2008 |
PDF |
05/2008 |
|
Mumps |
PDF |
01/2008 |
PDF |
11/2008 |
|
Neurologic
Syndrome |
PDF |
08/2009 |
(none) |
|
Other
Conditions |
PDF |
01/2008 |
(none) |
|
Pertussis |
PDF |
04/2008 |
PDF |
10/2009 |
|
Plague |
PDF |
01/2008 |
PDF |
06/2009 |
|
Polio |
PDF |
01/2008 |
PDF |
07/2008 |
|
Prion Diseases, Human
(CJD) |
PDF |
01/2008 |
PDF |
11/2007 |
|
Psittacosis |
PDF |
01/2008 |
PDF |
05/2008 |
|
PSP (Paralytic Shellfish Poisoning) |
PDF |
01/2008 |
PDF |
01/2008 |
|
Q Fever |
PDF |
01/2009 |
PDF |
12/2008 |
|
Rabies, Human |
PDF |
01/2008 |
PDF |
07/2008 |
|
Rabies Post-Exposure Prophylaxis
(PEP) |
PDF |
01/2008 |
PDF |
06/2008 |
|
Rare diseases of public health
significance |
PDF |
08/2009 |
PDF |
03/2008 |
|
Rash illness |
PDF |
01/2008 |
(none) |
|
Relapsing Fever |
PDF |
01/2008 |
PDF |
12/2007 |
|
Rubella |
PDF |
01/2009 |
PDF |
01/2009 |
|
Salmonellosis |
PDF |
01/2008 |
PDF |
08/2008 |
|
Shigellosis |
PDF |
01/2008 |
PDF |
10/2007 |
|
Syphilis |
PDF |
01/2009 |
PDF |
06/2008 |
|
Tetanus |
PDF |
01/2008 |
PDF |
06/2008 |
|
Trichinosis |
PDF |
01/2009 |
PDF |
02/2008 |
|
Tuberculosis (TB) |
PDF |
09/2008 |
PDF |
03/2009 |
|
Tularemia |
PDF |
01/2008 |
PDF |
12/2007 |
|
Typhoid fever |
PDF |
08/2008 |
PDF |
08/2008 |
|
Typhus |
PDF |
01/2008 |
PDF |
04/2008 |
|
Unexplained Critical Illness or
Death |
PDF |
01/2008 |
PDF |
06/2008 |
|
Vibriosis
|
PDF |
01/2008 |
PDF |
09/2007 |
|
West Nile Virus Disease |
PDF |
08/2009 |
PDF |
08/2009 |
|
Yellow Fever |
PDF |
01/2008 |
PDF |
07/2008 |
|
Yersiniosis |
PDF |
01/2008 |
PDF |
02/2008 |
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