Skip to main content
Oregon.gov Homepage

Oregon Notifiable Disease Case Report Forms



Instructions

  • Please fax the first part of the form (demographic information) to ACDP at 971-673-1100 as soon as possible, even if you have not yet completed the case investigation.
  • For reportable diseases lacking Oregon-specific investigative guidelines or case report forms, please contact the epidemiologist on call for assistance at 971-673-1111

Download Forms

NOTE: Forms are updated periodically. To ensure you have the most current version, we strongly recommend using Orpheus or DUDE.

Disease
Form
Last
Updated
Synched w/
 Orpheus?
Anaplasmosis - CDC formNo
Animal Bites and Rabies06/2003No
Anthrax04/2013No
Babesiosis - CDC form04/2015No
Botulism05/2013No
Brucellosis - CDC form
No
Campylobacteriosis02/2018Yes
Carbapenem-resistant Enterobacteriaceae06/2016No
Chikungunya - Draft form07/2014No
Cholera - See Vibrio infection, below
Coccidioidomycosis Valley Fever - CDC formNo
Colorado tick fever - CDC form No
Confidential Oregon Morbidity Report11/2015No
COVID-19 (Novel Coronavirus)
09/2020Yes
Cryptosporidiosis07/2018Yes
Cyclosporiasis12/2004No
Diphtheria07/2019No
Ehrlichiosis - CDC form
No
Escherichia coli O15702/2019Yes
Giardiasis10/2014Yes
Gonorrhea01/2014No
Haemophilus influenzae 09/2012Yes
Hantavirus Pulmonary Syndrome Screening Form - CDC form08/2002No
HCV testing pilot study01/2016No
HCV testing pilot study - Spanish10/2010No
Hepatitis A 11/2016Yes
Hepatitis B acute01/2015Yes
Hepatitis B chronic03/2010No
Hepatitis B Perinatal Case Management Form06/2018No
Hepatitis C acute01/2015Yes
Hepatitis C chronic01/2015Yes
Hepatitis E07/2011No

HIV Infection

 

No
Influenza-related Hospitalizations03/2019No
Legionellosis11/2003No
Listeriosis01/2004No
CDC Listeriosis Supplement - English   Spanish08/2019No
Lyme Disease6/2003No
Malaria1/2017Yes
Measles09/2018Yes
Meningococcal Disease03/2007No
Mumps10/2018Yes
Nontuberculous Mycobacterium (NTM) - Extrapulmonary03/2018Yes
Novel Influenza A, such as H5N1 or H7N911/2016No
Pertussis10/2020
Yes
Plague - CDC form2016No
Psittacosis06/2003No
Q-Fever - CDC form02/2008No
Rabies and Animal Bites06/2003No
Rickettsial Tick-borne Diseases - CDC form05/2008No
Rocky Mountain Spotted Fever - CDC form No
Rubella07/2019No
Salmonellosis03/2018Yes
SARS01/2005No
Sexually transmitted diseases
(chlamydia, gonorrhea, syphilis)
 No
Shiga-toxigenic E. coli07/2015Yes
Shigellosis01/2012No
Smallpox
Also available at cdc.gov
02/2004No
Specimen submission form links
Syphilis
Taeniasis/Cysticercosis02/2004No
Tetanus07/2019Yes
Trichinosis - CDC form No
Tuberculosis  12/2018No
Tularemia 06/2003No
Typhoid Fever04/2004No
Typhoid - CDC form03/2007No
Typhoid Carrier Agreement11/2003No
Vibrio infection - CDC form
Use for all Vibrio infection (cholera, vulnificus, etc.)
07/2006No
West Nile Virus05/2008No
Yersiniosis08/2005No

Your browser is out-of-date! It has known security flaws and may not display all features of this and other websites. Learn how

×