Communicable Disease Reporting
Forms
Confidential Morbidity Report Form (all except Tuberculosis and conditions reportable to DMV)
Confidential Morbidity Report Form (Tuberculosis only)
Confidential Morbidity Report Form (DMV)
Adult HIV/AIDS Case Report Form (ACRF)
Confidential Morbidity Report forms must be completely filled out. All of the requested information is essential, including the lab information for selected diseases. All phone, fax and mailed reports are to be made to the Disease Control Office in Riverside, with the following exceptions. Reports of Syphilis, Non-Gonococcal Urethritis, Pelvic Inflammatory Disease, and Gonococcal Infections should be faxed to the STD Reports fax number, (951) 358-6007.
To order CMR forms, contact the Riverside office listed below or download CMR as PDF.
Riverside
Phone - (951) 358-5107
Fax - (951) 358-5102
Disease Control Branch
P.O. Box 7600
Riverside, CA 92513-7600
For STD Reports:
Phone - (951) 358-7820
Fax - (951) 358-6007
For HIV Reporting:
Mail in a double envelope stamped “Confidential” TO:
HIV/STD Surveillance Unit
P. O. Box 7600
Riverside, CA 92513-7600
OR
FAX to (951) 358-6007 If faxing, please call (951) 358-7820 to confirm receipt
ALWAYS use CDPH form 8641-A rev. 05/13 (Adult), CDPH form 8641-P rev. 05/07(Pediatric) Confidential Case Report
*It is recommended that mailed reports are sent via Certified or Registered mail for tracking purposes.
Night, Weekend, and Holiday Emergency
Phone - (951) 358-5107
Fax - (951) 358-5102
Disease Control Branch
P.O. Box 7600
Riverside, CA 92513-7600