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    Infectious Disease Prevention Section
    Mail Code: 1927
    PO BOX 149347 - Austin, TX 78714-9347
    1100 West 49th Street, Suite G401
    Austin, TX 78714

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


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Reporting Forms

IDPS Home

Communicable Disease Reporting Forms


Epi2 Initial Provider Disease Report EPI-2 (98.4KB PDF)

This reporting form is to be used for most conditions as
it is designed to track the collection of the information
necessary to classify a case as confirmed, probable 
or dropped before it is entered into the notifiable
conditions' database.




Epi-1

Confidential Disease Report EPI-1  (78.3KB PDF) 

This reporting form collects information for multiple
cases on one piece of paper when that is appropriate.
It is not appropriate for disease case reports from
multiple reporters to be placed on the same sheet.




AFM Patient Summary Form (PDF, May 2021)

Contaminated Sharps Injury Reporting eform

Contaminated Sharps Injury Reporting Form  (PDF, July 2000)

Varicella (Chickenpox) Reporting Form (PDF, 361 KB March 2021)

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Last updated September 13, 2021