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    Disease / Condition-Specific Forms

    Acute Flaccid Myelitis​
    Meningitis (Bacterial)
    Anthrax
    Meningococcal Disease 
    Babesiosis​​
    Meningococcal Disease Supplemental Form​
    Botulism Infant MERS-CoV (PDF)
    Brucellosis MERS-CoV (Word)
    Carbapenem-resistant Organisms (CRO)​ Mumps 
    Chlamydia​ Outbreak (See below)
    Cholera and Other Vibrio Illnesses  (Form Guidance) Pertussis
    Cyclosporiasis
    Pneumonia in a Health Care Worker
    Dengue
    Polio
    Diphtheria
    Psittacosis
    Encephalitis
    Q-Fever
    Gastroenteritis ​​(Click Here for Instructions)
    Rickettsial (RMSF/Ehrlichiosis)
    Gonorrhea​
    Rocky Mountain Spotted Fever
    Haemophilus Influenzae
    Rubella
    Hansen's Disease (Leprosy)
    Rubella - Congenital
    Hantavirus
    SARS
    Hepatitis A Acute
    Smallpox
    Hepatitis B Acute
    Streptococcus - Group A​
    Perinatal Hepatitis B 
    Streptococcus - Group B
    Perinatal Hepatitis B Contact​
    Syphilis
    Hepatitis C (Initial)
    Tetanus
    Hepatitis C (Supplemental)​
    Toxic Shock Syndrome
    Influenza, Novel 
    Trichinosis
    Influenza-Associated Pediatric Death
    Tularemia
    Kawasaki Syndrome
    Typhoid and Paratyphoid Fever
    Legionellosis - Case Report Form
    Vaccine Adverse Event Reporting System (VAERS)
    Legionellosis - Supplemental Questionnaire 
    Varicella
    Leptospirosis
    Varicella Death Investigation
    Listeria Initiative​
    Varicella Death Guidelines
    Malaria​​
    Vibrio (Form Guidance)
    Measles​
    Viral Hemorrhagic Fever (VHF)
    Meningitis (Aseptic)​
    West Nile Virus

    Zika Virus


    Long-Term Care Facility Forms Adobe
    Acrobat
    Microsoft
    Word
    ​COVID-19 Outbreak (any facility type) PDF
    Gastroenteritis Outbreak (use for all facility types)
    P​DF

    Respiratory Outbreak PDF Word
    Scabies Outbreak PDF Word
    Drug Resistant Organism Outbreak PDF Word
         
    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
         
    Other Forms    
         
    ​COVID-19 Outbreak (any facility type) PDF
    Daycare Facility Outbreak (excluding gastroenteritis)
    PDF Word
    Hospital Outbreak (excluding gastroenteritis) PDF Word
    Gastroenteritis Outbreak (use for all facility types)
    P​DF


    Pertussis Outbreak PDF
    Word​
    School Outbreak (General)
    School Outbreak (Influenza or ILI)
    PDF
    PDF
    Word
    Word
    Waterborne Illness Outbreak PDF Word