Severe GAS Infection: Supplemental Form
Download a print version of the form:
- Severe GAS Infection: Supplemental Form (PDF: 82KB/1 pages)
- Severe GAS Infection Form Instructions (PDF: 75KB/3 pages)
Step-by-step instructions for filling out this form. Updated 7/2014
- 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
- All invasive GAS cases.
- After filling out the Severe GAS Infection Supplemental Form, please fax it to 651-201-5743.
- Download a printable form
- To receive a copy of either form by mail please call 651-201-5414.