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New Mexico Notifiable Condition Report Form

New Mexico clinicians and facilities report notifiable infectious diseases under NMAC 7.4.3.13 on this one-page form, dated October 2026. Its condition checklist is split in two: emergency conditions must be called in immediately, while routine conditions are reported within 24 hours by faxing the form, with lab results, to the NMDOH Infectious Disease Epidemiology Bureau.

Who completes it

The reporting facility and the person preparing the report complete the patient information, condition checklist and lab results. There is no patient section.

Submitting and payment

How to submit it
Phone emergency conditions to the 24/7 Reporting & Surveillance Hotline. Fax routine conditions within 24 hours, with a copy of relevant lab results, to the IDEB Surveillance Team.
Who pays
NMDOH lists no fee or billing code for the report.

Good to know

  • Conditions marked with an asterisk require laboratory or clinical samples to be sent to the state Scientific Laboratory Division.
  • Conditions marked with a double dagger, such as C. difficile and lab-confirmed influenza or RSV hospitalizations, are reported through sentinel surveillance sites.
  • Patient flags include pregnancy, food handler, and association with a nursing home, health care facility or day care, plus suspected foodborne or waterborne illness.
  • STDs go on the separate STD Morbidity Form and HIV on the confidential HIV Case Report Form, not this one.

Get the official form

Download the current version from the source each time; forms change without notice.

Notifiable Condition Report Form

Official pagePDF

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.

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Frequently asked questions

Which New Mexico conditions require an immediate call?

Those in the form's emergency column, including anthrax, botulism, cholera, diphtheria, measles, plague, poliomyelitis, rabies, smallpox and viral hemorrhagic fever. Call these in to the 24/7 hotline immediately rather than faxing. Routine conditions such as Lyme disease, salmonellosis and hepatitis are faxed within 24 hours.

What should be faxed with the New Mexico form?

A copy of the relevant laboratory results. The form's lab section has space for collection date, test and result, and instructs reporters to fax the form with lab results to the Infectious Disease Epidemiology Bureau's Surveillance Team. Samples for asterisked conditions also go to the Scientific Laboratory Division.