New Jersey providers use this paper report for a reportable communicable disease under N.J.A.C. 8:57, sent to the local health department where the patient resides. NJDOH now prefers electronic case reporting or direct entry in CDRSS, so the one-page CDS-1 is the fallback when a provider is not set up for those. It covers the patient, setting, case status, labs and clinical information.
The provider (physician, APN, PA or facility staff) completes the form except the shaded areas, which are for the local health department, including the CDRS ID and the reporting health officer.
Download the current version from the source each time; forms change without notice.
Communicable Disease Report
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Only as a fallback. NJDOH prefers electronic case reporting (eCR) or direct entry in its Communicable Disease Reporting and Surveillance System (CDRSS). Providers not authorized for those fax or securely email the CDS-1 to the local health department where the patient resides.
The one serving the municipality where the patient resides. The form is headed 'For Submission to Local Health Department', and the health department completes the shaded areas, assigns a CDRS ID and records the reporting health officer representative and the date initially reported.