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

STD Case Report Card

Minnesota Confidential STD Case Report form (PDF)

Please note:
The Minnesota Confidential STD Case Report Card was revised effective July 1, 2013.

Do not use the "Yellow Card" to report STDs.
Do not use the blue card graphic

Diseases to report on the STD Case Report Card

STD Case Report Card questions

Submitting the completed STD Case Report Card

  • 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

See also: HIV/AIDS Confidential Case Report Forms

Updated Thursday, September 17, 2015 at 12:40PM