Missouri physicians, hospitals and other required reporters use the CD-1 Disease Case Report for a communicable, environmental or occupational disease listed in 19 CSR 20-20.020. The fillable two-page form (MO 580-0779, 8-11) covers patient information, reporter, risk and background, disease, symptoms, diagnostics and treatment, with instructions on page 2, and goes to the local public health agency or DHSS.
The person named as 'Form Completed By' fills in every section; the box at the top is for public health agency use only. The reporting facility can be a physician office, outpatient clinic, hospital, laboratory, school or other.
Download the current version from the source each time; forms change without notice.
Disease Case Report
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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DHSS links the official list in 19 CSR 20-20 on the Secretary of State's site and posts a two-page reportable diseases reference list next to the CD-1. The form's Disease field asks you to name the condition as listed in 19 CSR 20-20.020, sections (1) and (2).
Any identifying number, such as the patient's Social Security number, medical record number, inmate number or DCN, and you indicate which one you gave. For homeless patients, check the box and give an address where they can be located, such as a shelter.
The medication or therapy prescribed, or the reason for not treating (such as false positive, previously treated or age), the dosage with units and frequency, start and end dates, duration in days, previous medications used and the previous treatment facility.