Confidential Morbidity Report - Humboldt IPA 2026

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  1. Click ‘Get Form’ to open the Confidential Morbidity Report in the editor.
  2. Begin by filling in the 'DISEASE BEING REPORTED' section. Clearly state the disease and provide the patient's last name, social security number, and birth date.
  3. Complete the 'Patient Information' fields, including first name, ethnicity, age, and address. Ensure all details are accurate for effective reporting.
  4. In the 'SEXUALLY TRANSMITTED DISEASES (STD)' section, indicate if applicable. Mark whether it is confirmed or suspected and provide treatment initiation dates.
  5. Fill out the 'TUBERCULOSIS (TB)' and 'VIRAL HEPATITIS' sections as necessary. Include any relevant test results and treatment information.
  6. Finally, review all entries for accuracy before submitting. Use our platform's features to save your progress or share with colleagues for verification.

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Notifiable disease lists infections caused by bacteria such as legionella. diseases or conditions caused by viruses such as influenza, COVID-19 and . infections spread by contact such as hepatitis. infections spread through the gastrointestinal route such as listeriosis. sexually transmitted infections such as chlamydia.
Diseases reportable to the CDC include: Anthrax. Arboviral diseases (diseases caused by viruses spread by mosquitoes, sandflies, ticks, etc.) such as West Nile virus, eastern and western equine encephalitis. Babesiosis. Botulism. Brucellosis. Campylobacteriosis. Cancer. Candida auris, clinical.
Clusters of cases or outbreaks should be reported to LAC DPH by phone at 888-397-3993 or 213-240-7821. For details about reporting online and for instructions on reporting by setting type visit our COVID-19 Acute Respiratory Illness Cluster Reporting page.
Food workers must also report to their manager if they have a Norovirus, Hepatitis A, Shigella, Salmonella, or E. coli infection. Managers must report these diagnoses to the local regulatory authority. The food worker should stay home until the regulatory authority gives them permission to work again.
The Disease Control and Epidemiology unit monitors the rates of reportable sexually transmitted diseases (STDs). These include gonorrhea, chlamydia and syphilis.

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All phone, fax, and mailed reports are to be made to the Disease Control Office, with the following exceptions: Reports of sexually transmitted diseases are to be faxed to (951) 358-6007 or mailed to the STD Program Office. ALWAYS use CDPH form 8641-A rev. 05/13 (Adult) to report cases 13 years of age and older.
California law (17 CCR 2505) requires laboratories to report positive tests for syphilis, gonorrhea, chlamydia trachomatis infections, including lymphogranuloma venereum.
Diseases you must report Notifiable diseaseWhether likely to be routine or urgent Enteric fever (typhoid or paratyphoid fever) Urgent Food poisoning Routine. Urgent if part of a cluster or outbreak Haemolytic uraemic syndrome ( HUS ) Urgent Infectious bloody diarrhoea Urgent38 more rows Sep 12, 2024

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