Minnesota Confidential STD Case Report Card - Minnesota Dept. of Health

Minnesota Confidential STD Case Report Form

The Minnesota Confidential STD Case Report Form is used to report lab confirmed cases of chancroid, chlamydia, gonorrhea, and syphilis in Minnesota residents to the Minnesota Department of Health.

On this page:
STD form & instructions
Frequently asked questions
Submitting the completed form
Diseases to report on this form

STD form & instructions

Frequently asked questions

  • If you have questions regarding the STD Case Report Card, please call 651-201-5414 or 877-676-5414.

  • Frequently Asked Questions about STD Reporting
    MDH fact sheet on STD reporting.

  • Do not use the "yellow card" to report STDs.
    no yellow card
  • If the second page does not contain any information (no untreated partners or not a case of syphilis) it does not have to be submitted blank.

Submitting the completed STD Case Report Card

  • When complete fax the form to 651-201-4040.
    • No cover sheet is required.
  • Forms may also be mailed (not necessary if faxed).
    • If mailing a form, please mark the envelope "confidential" and mail it to:
      MDH Infectious Disease Epidemiology, Prevention and Control,
      625 North Robert Street
      Post Office Box 64975
      St. Paul, MN 55164-0975

Diseases to report on this form

See also: HIV/AIDS Confidential Case Report Forms

Updated Tuesday, 10-Jan-2017 12:00:51 CST