IDPH Morb Report INEDSS2018 Public (61851 - Activated 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Patient Information' section. Ensure you print firmly and neatly, using a pen with dark ink. Fill in all circles completely.
3. Provide details such as the patient's first name, last name, address, phone number, and date of birth. Be sure to mark your answers clearly within the designated boxes.
4. In the 'Diagnosis' section, select the appropriate conditions diagnosed. Use checkboxes for multiple selections where applicable.
5. Complete the 'Laboratory Test(s) Related to Diagnosis' section by entering test dates and results accurately.
6. Fill out treatment information on the reverse side of the form, including any prescribed medications and their corresponding Rx codes.
7. Review all entries for accuracy before submitting. If assistance is needed, contact your local health department STD program.

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