New Mexico requires lab-confirmed chlamydia, gonorrhea and syphilis to be reported to the NMDOH STD Program within 24 hours, under NMSA 12-3-5 and 24-1-7 and NMAC 7.4.3.13. Clinicians do it on this one-page fillable form (08/21/2026), which records the patient, disease and stage, labs, treatment, pregnancy, PrEP and expedited partner therapy. Chancroid and PID can also be marked.
The clinician who diagnoses or treats the STD, or clinic staff on their behalf, completes the whole form; the treatment block asks for the name and title of the clinician.
Download the current version from the source each time; forms change without notice.
New Mexico Sexually Transmitted Disease Morbidity Form
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Within 24 hours. The form cites New Mexico statutes and NMAC 7.4.3.13, which require that patients with laboratory-confirmed chlamydia, syphilis and gonorrhea be reported to the NMDOH STD Program within 24 hours. Fax the completed form; the program also takes consultation calls.
The date of test collection, diagnostic test, result, specimen source and laboratory name, plus the reporting facility. Treatment rows ask for the date, drug and dose given and the clinician's name and title, followed by pregnancy status, estimated due date and PrEP status.