Minnesota Confidential STD Case Report Card
The Minnesota Confidential STD Case Report Card 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 Case Report Card
Diseases to report on the STD Case Report Card
STD Case Report Card questions
Submitting the completed STD Case Report Card: Fax to 651-201-4040
The Minnesota Confidential STD Case Report Card was revised effective July 1, 2013.
Confidential STD Case Report form (PDF: KB/2 pages)
- Do not use the "Yellow Card" to report STDs.
- Chancroid (Haemophilus ducreyi)
- Chlamydia trachomatis infection
- Gonorrhea (Neisseria gonorrhoeae)
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.
Asked Questions about STD Reporting
MDH fact sheet on STD reporting.
- When complete, fax the form to 651-201-4040.
- No cover sheet is required. If the back page is blank (no untreated partners or not a case of syphilis) it does not have to be submitted.
- Forms may also be mailed but is not necessary if faxed. 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