Provider case report of chlamydia or gonorrhea with treatment information.
- Completed by
- Health care provider who diagnoses or treats the infection
- Issued by
- Minnesota Department of Health (MDH), STD/HIV/TB Section
- Format
- Language
- English
Minnesota MDH Disease Report Card (Yellow Card)
Minnesota clinicians use this card, known as the yellow card, to report cases of most reportable infectious diseases in Minnesota residents, from Candida auris and CRE to hepatitis, Kawasaki disease, tuberculosis and zoster. Some reportable diseases have their own MDH forms instead. The one-page card (9/2024) collects patient, disease and lab information and is sent to MDH.
Who completes it
The physician or the person reporting for the clinic, hospital or institution completes the whole card and names the physician, PA or NP. There is no patient section.
Submitting and payment
- How to submit it
- Fax the card to MDH Infectious Disease Epidemiology, Prevention and Control, or mail it in an envelope marked confidential; cases can also be phoned in or reported through MEDSS. MDH asks that TB cases be reported by phone or fax, not mail.
- Who pays
- MDH lists no fee or billing code for the report.
Good to know
- Not every reportable disease belongs on the yellow card; MDH's Infectious Disease Reporting page lists disease-specific forms, such as the separate STI report forms.
- Sentinel surveillance items on the card include invasive candidiasis, CRAB, C. difficile, nontuberculous mycobacteria and RSV.
- Diseases that need immediate reporting are phoned in; MDH keeps a separate Report Immediately by Telephone page.
- Printed yellow cards can be ordered through MDH's Order Reporting Forms survey, and the fillable PDF can be completed on screen.
Get the official form
Download the current version from the source each time; forms change without notice.
Minnesota Department of Health Disease Report Card (Yellow Card)
Fill it with Vero
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
How this list is checked
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.
Frequently asked questions
What does the Minnesota yellow card ask?
Patient demographics and medical record number, pregnancy with due date and delivery hospital, occupation and child care contact, food handler status, hospitalization dates and discharge destination, status at reporting, the disease with case, suspected case or carrier status, onset date, lab findings, and the reporter, physician and lab.
Can I report a Minnesota case electronically?
Yes. MDH lists the Minnesota Electronic Disease Surveillance System (MEDSS) as a reporting method alongside fax, mail and phone. The yellow card itself is a one-page PDF that can be faxed, and printed cards are available from MDH.