California providers use CDPH 110b only for reporting tuberculosis to the local health department, within one working day. The 1-page fillable form records TB status (active confirmed or suspected, infected with no disease, or converter), site, skin test and IGRA results, imaging, bacteriology, rapid drug resistance, NAAT results and current treatment. Other reportable diseases use CDPH 110a.
The reporting health care provider or facility completes the whole form, including patient demographics, occupational or exposure setting, onset and diagnosis dates, and the reporting provider and laboratory.
Download the current version from the source each time; forms change without notice.
Confidential Morbidity Report (for reporting Tuberculosis)
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CDPH 110b instructs providers to report tuberculosis to the local health department within one working day. The form covers active disease, confirmed or suspected, as well as infection without disease and TST converters.
CDPH 110b is used only for tuberculosis and has TB-specific fields for skin tests, IGRA, imaging, smear, culture, drug resistance and treatment. Other reportable diseases go on CDPH 110a, the general Confidential Morbidity Report.