Vancomycin Intermediate and Vancomycin Resistant Staphylococcus aureus (VISA/VRSA) Case Report Form

There is also a supplemental reporting form for Vancomycin Intermediate and Vancomycin Resistant
Staphylococcus aureus (VISA/VRSA). When reporting on a VISA/VRSA Case Report Form, a Yellow Card (previously known as the "blue card") is not necessary. Before filling out the VISA/VRSA Case Report Form, please call MDH at 651-201-5414.

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Frequently Asked Questions
Returning the Completed Form
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VISA/VRSA Case Report Form

VISA/VRSA Case Report Form Frequently Asked Questions

  • If you have questions regarding the Serious Staph Case Report Form, please call 651-201-5414.

  • When reporting on a VISA/VRSA Case Report Form, a Yellow Card is not necessary.

Returning the Completed VISA/VRSA Case Report Form

  • After filling out the VISA/VRSA Case Report Form:

    1. Please call MDH at 651-201-5414

    2. Please return the completed form the MDH:
      • By mail (please mark the envelope "confidential") to:
        Infectious Disease Epidemiology, Prevention and Control
        625 North Robert Street
        Post Office Box 64975
        St. Paul, MN 55164-0975
      • By fax to:
        651-201-5743

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Updated Tuesday, 05-Mar-2013 13:18:02 CST