Nebraska clinicians report a reportable disease, poisoning or organism under 173 NAC 1 on this one-page fillable form (HHS-9-DC, Rev. 5/2016). It captures provider, patient, disease, lab and treatment information and goes to the DHHS Office of Epidemiology, or to the Douglas or Lancaster County health department for patients who live there.
The person reporting fills in the whole form and names the physician and clinic or institution. For patients under 19, the parent's name is also required.
Download the current version from the source each time; forms change without notice.
Healthcare Provider Confidential Disease Report (Reportable Diseases, Poisonings and Organisms)
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.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
DHHS lists providers, clinics, critical access hospitals, hospitals and any facility or place experiencing an outbreak. Health care providers, hospitals and laboratories report as required by the Reportable Diseases Regulations, 173 NAC 1, which set out what to report and how.
Cases in Douglas County go to the Douglas County Health Department's epidemiology program, and Lancaster County cases go to the Lincoln-Lancaster County Health Department. Cases in all other counties go to the DHHS Office of Epidemiology, which is printed on the form as the default destination.