Connecticut health care providers use PD-23 to report any reportable disease, emergency illness or health condition unless a specialized form applies. The 2026 edition includes the full reportable list and asks for disease, patient, report, laboratory and clinical information, with a viral hepatitis block. Category 1 diseases are phoned in the same day, with the PD-23 following within 12 hours.
The diagnosing health care provider or facility completes the form; hospital infection preventionists can enter cases directly in CTEDSS instead.
Download the current version from the source each time; forms change without notice.
Reportable Disease Case Report Form
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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Diseases marked with an asterisk on the PD-23 list, such as HIV, syphilis, gonorrhea, tuberculosis, chickenpox and occupational asthma, use their own forms, which go to specific DPH program fax lines listed on the form.
Category 1 diseases, such as measles or botulism, are phoned to DPH on the day of diagnosis or suspicion, with a PD-23 within 12 hours. Category 2 diseases need only the PD-23 within 12 hours. Both also go to the local Director of Health.