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    Contact Us

    Infectious Disease Control Unit
    Mail Code: 1960
    PO BOX 149347 - Austin, TX 78714-9347
    1100 West 49th Street, Suite T801
    Austin, TX 78714

    Phone: 512 776 7676
    Fax: (512) 776-7616


    E-mail

Investigation Forms

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INVESTIGATION

    Investigation Forms

    IDCU Home           Investigation Guidance

Alphabetical Listing of Investigation Forms

A-C

  • Anthrax Case Investigation Form (PDFPDF, 18 KB, August 2004)
  • Babesiosis Case Report Form (PDFPDF, 658 KB, June 2013)
  • Botulism Forms
    Foodborne Investigation Form (PDFPDF, 18KB, May 16, 2007)  
    Infant Investigation Form (PDFPDF, 20KB, May 16, 2007) 
  • Brucellosis Case Investigation Form (PDFPDF, 61.2KB, August 2004)
  • Chagas’ Disease Case Investigation Form (PDFPDF, 47KB, June 2013)

  • Cholera Surveillance Form, August 2008 revision (PDFPDF, 140KB, August 2007)
  • Communicable Disease Reporting Forms
    EPI-1 (PDFPDF, 78.3KB, October 2012)
    EPI-2 (PDFPDF, 66.6KB, October 2012)
  • Contaminated Sharps Injury Reporting Forms
  • Cyclosporiasis Investigation Form (PDF, July/2014) 

 


E-I


L-Q

  • Legionellosis Investigation Report Form , April 2002 revision (PDFPDF, 32KB, September, 2011) 
  • Leishmaniasis Case Investigation Form (PDFPDF, 51KB, June 2013) 
  • Listeria Case (with supplemental medical history form) Form, CDC (PDFPDF, 197KB) 
  • Lyme Case Investigation Form (PDFPDF, 74KB, October 2013)
  • Malaria Investigation Form, CDC (PDFPDF, 118KB)
  • Measles (Rash-Fever) Investigation Form (PDFPDF, November 2012)

  • Meningococcal (Neisseria Meningitidis) Investigation Form (PDFPDF, 194KB, May 2014) 
  • Mosquito Borne Illness Case Investigation Form (PDFPDF, 73KB, January 2012)
    Used for Dengue, California Encephalitis, Eastern/Venezuelan/Western Equine Encephalitis, St. Louis Encephalitis, West Nile Fever, and Yellow Fever
  • Multi-drug Resistant Organism Investigation FormForm Instructions (PDFPDF, May, 2014)
  • Mumps Investigation Form (PDFPDF, 34.3KB, March 2013)
  • Pertussis Investigation Form (WORD, December, 2013)
  • Pertussis Death Investigation Form, CDC (PDFPDF
  • Plague Case Investigation Form (PDFPDF, 67.0KB, November 2004)
  • Q Fever Investigation Form (PDFPDF, 62.7KB, August 2004)

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R-W

  • Rash-Fever Illness Case Track Record (PDF, November 2012)
  • Respiratory Disease Contact Tracking Form (PDFPDF, 30 KB September 2011)
  • Respiratory Disease Outbreak Summary Form (PDFPDF, September 2011)
  • Rickettsial Disease Case Investigation Form  (PDFPDF, 16KB, May 2006)
    Used for Anaplasmosis, Ehrlichiosis, Typhus, and Spotted Fever Group Rickettsiosis
  • Rubella (Rash-Fever) Investigation Form (PDFPDF, 98.4KB, May 2008)
  • Smallpox Investigation Forms, CDC 
    Evaluating Patients for Smallpox (PDFPDF, 182KB, March 4, 2002)
    Post Event Surveillance Form (PDFPDF, 147KB, June 2003)
  • Streptococcal Investigation Form (PDFPDF, 35KB, August, 2012 ) 
  • Taenia Tapeworm Investigation Form (PDFPDF link, 53.4Kb, April 2007)
  • Tetanus Investigation Form (PDFPDF, 150 KB, May 2014)
  • Tick-borne Relapsing Fever Case Investigation Form (PDFPDF, 54.4KB, August 2004)
  • Trichinosis Case Report Form (PDFPDF, 30KB, June 2013)
  • Tuberculosis Forms (including Report of Case and Patient Services, November 2003)
  • Tularemia Case Investigation Form (PDFPDF, 62.1KB, August 2004)
  • Typhoid Fever Surveillance Report, CDC (PDFPDF, 86KB, April 2009)
  • Varicella (Chickenpox)  Reporting Form  (PDFPDF, June 2012) 
  • Varicella Death Investigation Form, CDC  (PDFPDF, 91KB, May 9, 2005)
  • Vibriosis Surveillance Form, August 2008 revision   (PDFPDF, 140KB, August 200

  • Viral Gastroenteritis Outbreak Reporting Form (PDFPDF, 655KB, February 2004)
  • Viral Hepatitis Case Tracking Form (PDF, March 2013)
  • VRSA/VISA Case Report Form (PDFPDF, 65KB, January 3, 2011)
  • Yersiniosis Case Investigation Form, 1998 revision (PDFPDF, 13KB, May 16, 2007)
  • Waterborne Disease Outbreak Reporting Form (PDFPDF, 87KB)

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Last updated July 24, 2014
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