Minnesota Confidential STD Case Report Card
The Minnesota Confidential STD Case Report Card is used to report cases of chancroid, chlamydia, gonorrhea, and syphilis in Minnesota residents to the Minnesota Department of Health.On this page:
STD Case Report Card
Diseases to report on the STD Case Report Card
STD Case Report Card questions
Returning the completed STD Case Report Card
Order more STD Case Report Cards
STD Case Report Card
Please note:
The Minnesota Confidential STD Case Report Card was revised effective January 1, 2004.
- Confidential STD Case Report Card (PDF: 223KB/2 page) Updated 2009
This document is for view only.
- Submit only original cards to MDH - do not print or copy this Card.
- To receive STD Case Report Cards, please Order STD Case Report Cards.
- To receive STD Case Report Cards, please Order STD Case Report Cards.
- Do not use the "Yellow Card" to report STDs.
Diseases to report on the STD Case Report Card
- Reporting Chancroid (Haemophilus ducreyi)
- Reporting Chlamydia trachomatis infection
- Reporting Gonorrhea (Neisseria gonorrhoeae)
- Reporting Syphilis
STD Case Report Card questions
-
Instructions
for Completing the STD Confidential Case Report Card
- 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.
Returning the completed STD Case Report Card
After filling out the STD Case Report Card, please mark the envelope "confidential" and mail it to MDH at:
Infectious Disease Epidemiology, Prevention and Control
625 North Robert Street
Post Office Box 64975
St. Paul, MN 55164-0975
Order more STD Case Report Cards
- To order by phone, please call 651-201-5414 or 877-676-5414
- To order on-line, use our on-line order form.
