Nevada uses one form for all legally reportable diseases, from animal bites and STDs to HIV, hepatitis, TB and COVID-19. NAC Chapter 441A requires physicians, nurses, labs, facilities and others to report cases, suspect cases and carriers within 24 hours to the local health authority. The four-page packet (updated September 2022) includes the disease list, instructions and contacts.
The attending physician or the person reporting for the facility completes the form, and a checkbox marks forms completed by the local health department. Attaching a patient face sheet is an acceptable way to give demographics.
Download the current version from the source each time; forms change without notice.
Confidential Morbidity Report Form
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Under NAC 441A, physicians, veterinarians, dentists, chiropractors, registered nurses, directors of medical facilities, medical laboratories, blood banks, school authorities, college administrators, directors of child care facilities, nursing homes and correctional institutions. Failure to report is a misdemeanor and may bring an administrative fine for each violation.
The instructions say an SSN greatly assists the investigation by allowing easier access to laboratory and medical records. The form also asks for the medical record number, primary language spoken to help arrange translators, and incarceration status, with the facility named in the comments.