VISA/VRSA Case Report Form - Minnesota Dept. of Health

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).

Before filling out the VISA/VRSA Case Report Form, please call MDH at 651-201-5414 or 1-877-676-5414.

On this page:
VISA/VRSA Form
Frequently Asked Questions
Returning the Completed Form

VISA/VRSA Case Report Form

Frequently Asked Questions

  • Before filling out the VISA/VRSA Case Report Form, please call MDH at 651-201-5414 or 1-877-676-5414.

  • When reporting on a VISA/VRSA Case Report Form, a Yellow Card is not necessary.
    no yellow card

Returning the Completed VISA/VRSA Case Report Form

  • Please return the completed form to 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

Diseases to report with this form

More about these diseases

Updated Tuesday, 10-Jan-2017 12:00:52 CST