Report in 3 easy steps!
1Determine the reporting requirement for the disease using
one or more of the following tools:
- View reporting conditions on our Requirements page
- Download a 2-page Disease Classification chart
- Disease-specific fact sheets and additional information
2Complete a report form with all available information pertaining to the patient,
lab testing, provider and disease (click on each to expand option info):
Disease Specific Forms
Adult HIV/AIDS Confidential Case Report Form
Animal Bite Intake Form
Harmful Algal Bloom Related Illness Surveillance Form
Influenza Associated Hospitalization Case Report Form
Influenza Associated Pediatric Death Case Report Form
Legionnaire's Disease Case Report Form
Lyme Disease Case Report Form
Malaria Case Surveillance Report Form
CLASS A Diseases
All suspected or confirmed cases of class A reportable disease, bioterrorism event, or other infectious disease emergency must be reported IMMEDIATELY by phone as soon as knowledge or suspicion of a case exists.
- What is a Class A Disease?
- During business hours (8:00 a.m. - 5:00 p.m. Mon - Fri excluding holidays):
- Call (937) 642-2053 and state you are reporting a Class A disease. You will be transferred to the appropriate health department personnel.
- After hours: Call (937) 645-4100. Tell the Union County Sheriff's Office dispatcher that you are calling to report a Class A disease. The dispatcher will take your contact information and your call will be returned shortly by health department personnel.
** To ensure accuracy of information left by phone, please fax a copy of the completed Ohio Confidential Reportable Disease Form
3After collecting all required information and completing the form, report the disease using one of the following options:
- ONLINE FORM
- Ohio Confidential Reportable Disease Form is a generic form for most reportable diseases. This is a fillable pdf for completion and printing - the completed form cannot be saved electronically on most computers.
- FAX: (937) 642-9725
- CALL: (937) 642-2053
- EMAIL: firstname.lastname@example.org
- MAIL: Union County Health Dept, IDRS | 940 London Ave, Suite 1100 | Marysville, OH 43040