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CDC Anthrax Case Investigation Form

​Cholera and Other Vibrio Illness Case Report

CDC Cholera and Other Vibrio Illness Seafood Investigation Report (Section 5 of COVIS, CDC OMB 0920-0728): This form should be used to report seafood investigations associated with Cholera and Vibrio illness.

​Hepatitis B, Acute

​Rabies, Human

Rabies, Animal

​Human Rabies Case Report

Animal Rabies Case Report

​Rubella, (German Measles)

Congenital Syndrome

Rubella (German Measles) Case Report

​Congenital Rubella Syndrome Case Report

​​Syphilis

California Congenital Syphilis (CS) Case Investigation and Report

​Out of State Syphilis Record Search Request

Tetanus Surveillance Worksheet

Tetanus Surveillance Worksheet Instructions

​Typhoid Carrier Agreement

Typhoid Carrier Case Report

Typhoid Carrier-Register-Semiannual Update

​Varicella (Chickenpox) Hospitalization Case Report

Varicella Death Investigation Worksheet

Varicella Death Investigation Worksheet-Instructions

Varicella Outbreak Report

​Viral Hemorrhagic Fever, Human

Viral Hemorrhagic Fever, Animal

​Viral Hemorrhagic Fever Case Report

Viral Hemorrhagic Fever (Animal) Case Report​

​Acute Respiratory Illness Outbreak

(Community and Congregate Settings)

​Acute Respiratory Illness Outbreak 

(Community and Congregate Settings)

​Foodborne Disease Outbreak Report

​Foodborne Disease Outbreak Report-California modification of CDC NORS 52.13

Guidelines for Completing the Foodborne Disease Outbreak Report CDPH 8567-Adapted from NORS 52.13 Guidance Document for NORS Users reporting foodborne, person-to-person, and animal contact.

NORS Guidance for Contributing Factors

Case-Control Study Table (For calculating odds ratios, 95% confidence intervals, and chi-square p-values)

Food-Specific Attack Rate Table (For calculating risk ratios, 95% confidence intervals, and chi-square p-values)

​Waterborne Disease Outbreaks ​

​Complete Form (read only, do not use for reporting)

The complete CDC 52.12 contains sections for 4 categories of water and is posted here for reference only. Please choose the appropriate form below based on the type of water associated with the outbreak being reported.

​Recreational Water-Untreated (fillable)

This version of CDC 52.12 should be used to report waterborne disease outbreaks associated with untreated recreational water.

​Water NOT Intended for Drinking or Water of Unknown Intent

​Water NOT intended for Drinking or Water of Unknown Intent (fillable)

This version of CDC 52.12 should be used to report waterborne disease outbreaks associated with water not intended for drinking (excluding recreational water) or water of unknown intent.

​​Use this form for reporting all conditions except Tuberculosis and conditions reportable to DMV. Initial report required from provider for any reportable disease.