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Page 1 of 3Passive Reporting of COVID-19 cases in Vaccinated Individuals Details of Clinician Reporting Case in Partially or Fully Vaccinated Individuals Name (incl. title) of Reporting ClinicianOrganisationContact
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Obtain the CDC report form from the official CDC website or from your healthcare provider.
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Fill out your personal information such as name, date of birth, and contact information.
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Provide details about your symptoms and when they first started.
04
Include any relevant medical history or underlying health conditions.
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06
Sign and date the report where indicated.
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Submit the completed CDC report to the appropriate healthcare authorities or your healthcare provider.

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Healthcare providers
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Individuals experiencing symptoms of infectious diseases
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Individuals with potential exposure to infectious diseases
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Healthcare authorities for disease tracking and monitoring purposes
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CDC report looks at surveillance data for various diseases and health-related issues.
Healthcare providers, laboratories, and public health agencies are required to file CDC report.
CDC report can be filled out online through the CDC website or submitted via mail.
The purpose of CDC report is to monitor and track disease outbreaks, trends, and public health threats.
Information such as demographics of affected individuals, symptoms, laboratory test results, and possible sources of exposure must be reported on CDC report.
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