Active Bacterial Core Surveillance (ABCs) Case Report Form - Minnesota Dept. of Health

Blastomycosis Report Forms

These report forms are used to report blastomycosis in humans or animals to the Minnesota Department of Health.

On this page:
Blastomycosis forms
Frequently asked questions
Returning the completed forms
Diseases to report on these forms

Blastomycosis forms

Frequently asked questions

  • If you have questions regarding this form, please call 651-201-5414.

Returning the completed forms

After filling out this form, please return to MDH:
  • By fax to:
    651-201-5730

Diseases to report these forms

More about this disease

Updated Thursday, 30-Nov-2017 15:32:30 CST