Confidential Morbidity Reports & Reporting Forms

The Communicable Disease Section performs surveillance, investigates cases and outbreaks of communicable diseases including gonorrhea, chlamydia, syphilis, and HIV/AIDS and provides educational activities designed to reduce or control the incidence of infectious disease in the County of San Bernardino.
 
The Communicable Disease Section relies on our public health partners to report more than 85 communicable diseases as mandated by California law. For more information on our activities and a list of reportable diseases and conditions, view our Why Report? document.
 
The Confidential Morbidity Report (CMR) is required to be completed by providers. On the reverse of the CMR is a list of conditions reportable by providers under California Code of Regulations Title 17 Section 2500.
 
For conditions that are immediately reportable, please contact the Communicable Disease Section (CDS) at 1 (800) 722-4794, Monday-Friday 8 a.m.-5 p.m. After hours, please call (909) 356-3805 and ask for the Public Health Duty Officer.
 

Confidential Morbidity Reports (CMR)

Respiratory Syncytial Virus (RSV) has been reportable in San Bernardino County since 2002 for cases of all ages as a locally reportable condition. In 2016 year, RSV deaths in persons under 5 became reportable in California. State reporting requirements do not supersede what the local health officer has in place. Providers still need to report all cases, not just deaths for anyone with RSV in San Bernardino County.

crm reporting
Forms By Disease

 
STD:
Use the Confidential Morbidity Report Form – All Conditions Except TB to DMV to report STDs.
Learn how to report STDs on the CMR.
 
HIV:
HIV/AIDS can be reported by providers by completing the HIV/AIDS Case Report Form. This form can be faxed by provider offices to CDS at (909) 387-6377 or mailed via traceable mail.
 
HIV/AIDS laboratory reports including positive antibodies, viral loads, and CD4 counts can be mailed by traceable mail to CDS. Faxing by laboratories of HIV laboratory reports to CDS is not permitted.
 
HIV Form Mailing Address:
Public Health Communicable Disease Section
Attn: Kimberly Woods
351 N Mountain View Avenue Rm 104
San Bernardino, CA 92415

 
 
 
TB:
Confidential Morbidity Report Form – Tuberculosis (This form is only to be used to report a positive tuberculin skin test or IGRA)
Initial TB Case Report Form
TB Case/Suspect Report Form for Hospitalized Patients
 
Hepatitis:
Hospital Hepatitis B Report Form
Report a Case of Perinatal Hepatitis B
Perinatal Hepatitis B Form
 
Other CDS Forms:
Web-based disease reporting is also available for provider offices via the CalREDIE Provider Portal.
 
Electronic laboratory reporting to the State Office of AIDS is available for interested laboratories.
 
Optional Use Medical Exemption Form