Malaria Case Report Form

This form can be used to report Malaria (Plasmodium spp.) to the Minnesota Department of Health. Please report all patients (symptomatic or asymptomatic) who test positive for Plasmodium species.

On this page:
Form
Frequently asked questions
Diseases to report on this form
Returning the completed form
Order more forms

Form

Download a print version of the form:

Frequently asked questions

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

  • When reporting on this form, a Yellow Card is not necessary.
    yellow card

Diseases to report this form

Returning the completed form

  • After filling out this form, please return to MDH:

    • By mail (please mark the envelope "confidential") to:
      Infectious Disease Epidemiology, Prevention and Control
      625 North Robert Street
      Post Office Box 64975
      St. Paul, MN 55164-0975
    • By fax to:
      651-201-5743

Order more forms

Updated Thursday, January 09, 2014 at 11:47AM