{"id":287,"date":"2024-04-08T03:42:33","date_gmt":"2024-04-08T03:42:33","guid":{"rendered":"https:\/\/hca.venturacounty.gov\/public-health\/?page_id=287"},"modified":"2026-03-05T00:30:38","modified_gmt":"2026-03-05T00:30:38","slug":"disease-reporting-forms","status":"publish","type":"page","link":"https:\/\/hca.venturacounty.gov\/public-health\/disease-reporting-forms\/","title":{"rendered":"Disease Reporting Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"287\" class=\"elementor elementor-287\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-717aca2 e-flex e-con-boxed e-con e-parent\" data-id=\"717aca2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-85f23f4 e-con-full e-flex e-con e-child\" data-id=\"85f23f4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-768 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-global elementor-global-768 elementor-widget-icon-list\" data-id=\"768\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_parent&quot;:&quot;yes&quot;,&quot;sticky_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;],&quot;sticky_offset&quot;:0,&quot;sticky_effects_offset&quot;:0,&quot;sticky_anchor_link_offset&quot;:0}\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/communicable-disease\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-home\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">CD Office<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/disease-reporting-forms\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-arrow-alt-circle-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Disease Reporting Forms <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/diseases-and-conditions\/\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-arrow-alt-circle-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Diseases and Conditions<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/hot-tips\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-arrow-alt-circle-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Public Health Advisories <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/public-health-orders\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-arrow-alt-circle-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Public Health Orders<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/respiratory-dashboard\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-arrow-alt-circle-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Respiratory Dashboard<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0997dc4 e-con-full e-flex e-con e-child\" data-id=\"0997dc4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-716ecad e-con-full e-flex e-con e-child\" data-id=\"716ecad\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f2bb764 elementor-widget elementor-widget-heading\" data-id=\"f2bb764\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Disease Reporting Forms<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f4b6602 elementor-widget elementor-widget-text-editor\" data-id=\"f4b6602\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This page serves as a centralized location for healthcare providers to get updates, guidance and required forms on diseases and health conditions in Ventura County. Providers must report all reportable suspected and confirmed communicable diseases or other unusual conditions to Ventura County Public Health&#8217;s\u00a0<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/for-providers\/communicable-disease-office\/\" target=\"_blank\" rel=\"noopener\">Communicable Disease office<\/a>\u00a0by filing out a Confidential Morbidity Report (CMR). Please see below under\u00a0<em>Communicable Disease Reporting Forms<\/em>\u00a0for the appropriate CMR form.<\/p><p>Please review the\u00a0<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2025\/07\/CMR-_Reportable-Diseases_07-2025.pdf\" target=\"_blank\" rel=\"noopener\">current list of reportable diseases<\/a>. All health care providers and laboratories are required to submit a CMR on applicable diseases and conditions within a specified timeframe.<\/p><p>Patients newly diagnosed with HIV\/AIDS or previous diagnosis, or relocation to Ventura County should be reported to the HIV\/AIDS office by calling 805-652-5780.\u00a0<strong>Please do not submit a CMR form for HIV\/AIDS diagnosis.<\/strong><\/p><p style=\"text-align: center;\"><strong>Communicable Disease Reporting Forms<\/strong><\/p><ul><li><a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2025\/07\/CMR_07-2025_Fillable.pdf\" target=\"_blank\" rel=\"noopener\">CMR Form<\/a>\u00a0&#8211; Use this form to report all conditions except TB, HIV\/AIDS, STIs and conditions reportable to DMV.<\/li><li><a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2024\/10\/CMR_STIs-Only_10-2024.pdf\" target=\"_blank\" rel=\"noopener\">CMR Form (STIs)<\/a>\u00a0&#8211; Use this form to report all sexually transmitted infections.<\/li><li><a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2026\/02\/TB-CMR_02-26-2026.pdf\" target=\"_blank\" rel=\"noopener\">CMR Form (TB)<\/a>\u00a0&#8211; Use this form to report positive\u00a0PPD or Quantiferon\/IGRA or latent TB infection.<\/li><li><a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2024\/04\/cdph110c-dmv-10-2011_vcph_re.pdf\" target=\"_blank\" rel=\"noopener\" data-uw-pdf-br=\"2\" aria-label=\"CMR Form (DMV) - open in a new tab\" data-uw-rm-ext-link=\"\" data-uw-pdf-doc=\"\">CMR Form (DMV)<\/a>\u00a0&#8211;\u00a0Use this form for reporting lapses of consciousness or control, Alzheimer&#8217;s disease or other conditions which may impair the ability to operate a motor vehicle safely.<\/li><li><a href=\"https:\/\/hca.venturacounty.gov\/public-health\/wp-content\/uploads\/sites\/3\/2024\/04\/TB_Suspect_Request_for_Hospital_Discharge_Form_fillable_2019-05-29_RE.pdf\" target=\"_blank\" rel=\"noopener\" data-uw-pdf-br=\"2\" aria-label=\"TB Case\/Suspect Request for Hospital Discharge Form - open in a new tab\" data-uw-rm-ext-link=\"\" data-uw-pdf-doc=\"\">TB Case\/Suspect Request for Hospital Discharge Form<\/a>\u00a0&#8211; Use this form to request discharge or transfer for TB case or suspected TB case. Complete the form and FAX to 805-385-9445.<\/li><\/ul><p>To file a Communicable Disease reporting form (except for HIV\/AIDS), complete the appropriate CMR form and e-mail or FAX the CMR form according to the instructions on the first page of the form.<\/p><p><strong>For Communicable Disease reporting (except for TB and HIV\/AIDS)<\/strong><\/p><ul><li>FAX forms to:\u00a0<span class=\"baec5a81-e4d6-4674-97f3-e9220f0136c1\">805-981-5200<\/span><\/li><li>Email:\u00a0<a href=\"mailto:VCPH-ID@ventura.org\" aria-label=\"send an email to VCPH-ID@ventura.org\" data-uw-rm-vglnk=\"\">VCPH-ID@ventura.org<\/a><\/li><\/ul><p>If you have question on reporting, call the Communicable Disease office at <span class=\"baec5a81-e4d6-4674-97f3-e9220f0136c1\">805-981-5201. For after-hours, please call 805-214-7057.<\/span><\/p><p><strong>For TB reporting or information<\/strong><\/p><ul><li>Fax forms to: 805-385-9445<\/li><\/ul><p>If you have questions on TB reporting, call the TB Specialty Clinic at 805-385-9451 or visit the\u00a0<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/clinics-and-laboratory\/tuberculosis-specialty-clinic\/\" target=\"_blank\" rel=\"noopener\" data-uw-rm-brl=\"PR\" data-uw-original-href=\"https:\/\/hca.venturacounty.gov\/tuberculosis-specialty-clinic\" aria-label=\"TB Specialty Clinic website - open in a new tab\" data-uw-rm-ext-link=\"\">TB Specialty Clinic website<\/a>.<\/p><p><strong>For HIV\/AIDS reporting or information<\/strong><\/p><ul><li>Call 805-652-5780 or\u00a0visit the\u00a0<a href=\"https:\/\/hca.venturacounty.gov\/public-health\/hiv-aids\/hiv-aids-center\/\" target=\"_blank\" rel=\"noopener\">HIV\/AIDS Program website<\/a>.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1b692b9 e-flex e-con-boxed e-con e-parent\" data-id=\"1b692b9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>CD Office Disease Reporting Forms Diseases and Conditions Public Health Advisories Public Health Orders Respiratory Dashboard This page serves as a centralized location for healthcare providers to get updates, guidance [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-287","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/pages\/287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/comments?post=287"}],"version-history":[{"count":0,"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/pages\/287\/revisions"}],"wp:attachment":[{"href":"https:\/\/hca.venturacounty.gov\/public-health\/wp-json\/wp\/v2\/media?parent=287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}