Severe GAS Infection: Supplemental Form

This form is used to report all invasive cases of Group A Streptococci to MDH within one working day. This form is supplemental to the ABCs Case Report Form. Please return both forms to MDH.

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Forms
Frequently asked questions
Diseases to report on this form
Returning the completed form
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Forms

Download a print version of the form:

Frequently asked questions

Instructions

  • This form is supplemental to the ABCs Case Report Form. Please return both forms to MDH.

  • If you have questions regarding these forms, please call 651-201-5414.

  • When reporting on a Severe GAS Infection Supplemental Form, a Yellow Card is not necessary

Diseases to report these forms

  • All invasive GAS cases.

Returning the completed forms

  • After filling out the Severe GAS Infection Supplemental Form, please fax it to 651-201-5743.

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Updated Friday, July 11, 2014 at 02:48PM