New Jersey providers who cannot enter a gonorrhea case directly in CDRSS report it on this one-page fillable form (MAR 23). It records the patient, pregnancy, reason for exam, HIV testing and PrEP, sites of infection, treatment date and regimen, whether partners received medication, and whether chlamydia labs were also positive. The lab report goes with it.
The examining provider or clinic staff completes it, naming both the person completing the form and the examining provider in the reporting clinic block.
Download the current version from the source each time; forms change without notice.
Gonorrhea 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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NJDOH says STD reports should be made directly in CDRSS. If that isn't possible, call the STD Program or fax the STD-11b with the lab report to its confidential line. NJDOH lists a CDRS administration contact for questions about system access.
Under N.J.S.A. 26:4-48.2, a provider can give a patient diagnosed with an STD medication or prescriptions for their sex partners without a medical evaluation of the partners. NJDOH posts provider, patient and partner FAQs and drug sheets, and the STD-11b records whether partner medication was given.