Varicella Reporting Form
This form can be used to report varicella (chickenpox) to the Minnesota Department of Health.
Varicella report form
- Varicella Report Form (PDF)
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.
Returning the completed formAfter filling out this form, please return to MDH:
- By fax to: 651-201-4820 (for vaccine-preventable diseases) or 651-201-5743 (for all reportable diseases)
- By mail (please mark the envelope "confidential") to:
Infectious Disease Epidemiology, Prevention and Control
625 North Robert St.
PO Box 64975
St. Paul, MN 55164