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Disease / Condition-Specific Forms

Acute Flaccid Myelitis​
Histoplasmosis
​Tickborne Rickettsial (RMSF/Ehrlichiosis/Anaplasmosis)
​Anthrax
​Influenza-Associated Pediatric Death
​Toxic Shock Syndrome
​Babesiosis​​
​Kawasaki Syndrome
Trichinosis
​Blastomycosis
​Legionellosis 
​Tularemia
Brucellosis
Leptospirosis​​​
​Typhoid and Paratyphoid Fever
​Carbapenem-resistant Organisms (CRO)​
​​Listeria Initiative
​Vaccine Adverse Event Reporting System (VAERS)
​Chlamydia​
Malaria
​Cholera and Other Vibrio Illnesses  (Form Guidance)
​Measles
​​Varicella Death​ (Form Guidance)
​​​Cocciodioidomycosis
​Meningitis (Aseptic)
Vibrio (Form Guidance)
Cronobacter
​Meningitis (Bacterial)
​Viral Hemorrhagic Fever (VH​​F)
​​​Cyclosporiasis​
​Meningococcal Disease
​West Nile Virus
Dengue
Meningococcal Disease Supplemental Form​
​Zika Virus​
​​Diphtheria
MERS-CoV (Word)

Encephalitis
​Mumps 
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​Gastroenteritis ​​(Click Here for Instructions)
​Outbreak (See below)​

​Gonorrhea​
​Pertussis​

​Haemophilus Influenzae
​Pneumonia in a Health Care Worker
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​Hansen's Disease (Leprosy)
​Polio
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​Hantavirus
Psittacosis
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​Hepatitis A Acute
Q-Fever
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​​Hepatitis B Acute
​​Rubella​
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Hepatitis B Chronic​
S​ARS
​​​
​Perinatal Hepatitis B ​
Smallpox
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Perinatal Hepatitis B Contact
​​Streptococcus - Group A​​​
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​​Hepatitis C Acute 
​Streptococcus - Group B
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​Hepatitis C or D Chronic
​​Syphilis
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​​Hepatitis C Perinatal​
​Tetanus
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Outbreak Summary Report Forms PDF Microsoft
Word
​COVID-19 Outbreak (all facility types)
 ​PDF ​
​Non-COVID-19 Respiratory Outbreak (all facility types)
​PDF
​
Gastroenteritis Outbreak (all facility types)
 P​DF
Scabies Outbreak PDF Word
Other Daycare Outbreak
 PDF
 Word
​Other School Outbreak
​PDF
​Word
​Other Hospital Outbreak
​PDF
​Word
​Waterborne Illness Outbreak
​PDF
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Foodborne Outbreak Forms    
National Outbreak Reporting System (NORS) Form 52.13
 PDF
National Outbreak Reporting System (NORS) Form 52.13 Guidance PDF  
NORS Guidance Appendices:
 
​​Appendix A: Mode of Transmission for Certain Beverages and Foods or Drinks Containing Ice
 ​PDF ​
​​Appendix B: Reporting Foodborne and Animal Contact Multistate Exposure and Residency Outbreaks
 ​PDF ​
​​Appendix C: Freedom of Information Act (FOIA) Requests and Other Requests for NORS Data
 ​PDF ​
​​Appendix D: ​NORS Guidance for Contributing Factors (CF) in Foodborne Outbreak Reports
 ​PDF ​
​​Appendix E: Available Picklist Values    ​ 
 ​PDF ​
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