COVID-19 Case Report Form COVID-19 Case Report Form 2026

1. Click ‘Get Form’ to open the COVID-19 Case Report Form in the editor.
2. Begin by filling out the Reporter Information section. Enter today’s date, hospital or clinic name, clinician's name, and contact information for both the clinician and disease reporter.
3. Next, move to the COVID-19 Testing Information section. Input the lab name, specimen collection date, and select the type of specimen collected.
4. In the Patient Information section, provide details such as first and last name, phone number, address, city, zip code, county, state, date of birth, age, and sex. Indicate if the patient works in a healthcare facility or congregate setting and provide relevant details.
5. Proceed to Clinical Information. Fill in symptom onset date and hospitalization status. Include any underlying conditions that apply to the patient.

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