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    Infectious Disease Control Unit
    Mail Code: 1960
    PO BOX 149347 - Austin, TX 78714-9347
    1100 West 49th Street, Suite T801
    Austin, TX 78714

    Phone: 512 776 7676
    Fax: (512) 776-7616


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Investigation Forms

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 IDCU Home               Investigation Guidance

Alphabetical Listing of

  • Case Investigation Form
  • Outbreak Investigation Form
  • Death Investigation Form
  • Control Measure Tracking Form
  • Reporting Form
  • Miscellaneous – Food History, Hypothesis Generating, etc.


  Click on the link to view or download the form.

A-C      E-I      L-Q      R-W

A-D 

  • Acute Flaccid Myelitis (AFM) Case Investigation Form (Word, 72.9 KB, June 2016)
  • Amebic Meningitis/Encephalitis Case Investigation Form (PDF, 163 KB, January 2012)
  • Anthrax Case Investigation Form (PDFPDF, 18 KB, August 2004)
  • Arboviral Case Investigation Form (PDFPDF, 58 KB, February 2017)
  • Ascariasis Case Investigation Form (PDFPDF, 95 KB, February 2016)
  • Babesiosis Case Investigation eForm (PDFPDF, 658 KB, June 2013)
  • Botulism Forms
    Botulism Foodborne Case Investigation Form (PDFPDF, 18 KB, May 2007)  
    Botulism Infant Case Investigation Form (PDFPDF, 20 KB, May 2007)
    Botulism Control Measure Tracking Form (PDFPDF, 74 KB, December 2011)
  • Brucellosis Case Investigation Form (PDFPDF, 61.2 KB, January 2015)
  • Chagas Disease Case Investigation Form (PDFPDF, 47 KB, June 2013)
  • Cholera Case Investigation eForm (PDF, 697 KB, June 2017) Guidance (PDFPDF, 436 KB, June 2017)   
  • Communicable Disease Reporting Forms 
    EPI-1 Infectious Disease Reporting Form (multiple) (PDFPDF, 78.3 KB, January 2017)
    EPI-2 Infectious Disease Reporting Form (single) (PDFPDF, 66.6 KB, January 2017)
  • Contaminated Sharps Injury Reporting eForm; Contaminated Sharps Injury Reporting Form (PDF, 107 KB, July 2000)
  • Coronavirus, Novel; Middle East Respiratory Syndrome (MERS) – Case Investigation Form (PDF, 192 KB, December 2015)
  • CRE Case Investigation Form (PDFPDF, 169 KB, January 2016)
  • Cyclosporiasis Case Investigation Form (PDFPDF, 1 MB, July 2016)
  • Dengue Case Investigation Form (PDFPDF, 58 KB, June 2016)

E-I

  • Ebola Virus Case Investigation Form ( PDFPDF, 219 KB, November 2014)
  • Echinococcosis Case Investigation Form ( PDFPDF, 42 KB, January 2016) 
  • Escherichia coli O157:H7 and Hemolytic Uremic Syndrome Case Investigation Form, (PDFPDF, 205 KB, September 2014) 
  • Escherichia coli O157:H7 Food History Listing Form (PDFPDF, 62 KB)
    E coli STEC Control Measure Tracking Form (PDFPDF, 82 KB, December 2011)
  • Fascioliasis Case Investigation Form (PDFPDF, 94 KB, February 2016)
  • Foodborne Outbreak Investigation Form (PDFPDF, 146 KB, March 2008)
  • Haemophilus influenzae Case Investigation Form (PDFPDF, 157 KB, December 2015)
  • Hansen's Disease Forms
  • Hantavirus Pulmonary Syndrome Case Investigation eForm (PDFPDF, 187 KB, May 2010)
  • Hepatitis A Case Investigation Form  (PDF, 212 KB, May 2014)
    HAV Control Measure Tracking Form (PDFPDF, 82 KB, December 2011)
  • Hepatitis B Case Investigation Form  (PDF, 212 KB, May 2014)
  • Hepatitis C Case Investigation Form (PDF, 212 KB, May 2014)
  • Hepatitis E Case Investigation Form (PDF, 212 KB, May 2014)
  • Viral Hepatitis Case Investigation eForm ( Word, 226 KB, May 2016)
  • Hepatitis B, Perinatal Case Management Forms
  • Hookworm Case Investigation Form (PDFPDF, 95 KB, February 2016)
  • Hypothesis Generating Questionnaire for Gastroenteritis Complaints (PDFPDF, 17.68 KB, April 1999)
  • Influenza-Associated Pediatric Death Investigation Form, (PDFPDF, 133 KB, July 2016)   Form Instructions (PDFPDF, 171 KB, July 2016)
  • Influenza, General Case Investigation Form (PDFPDF, 35 KB, September 2011)
  • Influenza, Supplemental Investigation Questions (PDFPDF, 42 KB, September 2011)

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L-Q

  • Legionellosis Case Investigation Form, April 2002 revision (PDFPDF, 32 KB, September, 2011) 
  • Leishmaniasis Case Investigation Form (PDFPDF, 51 KB, June 2013) 
  • Listeria Case Investigation Form, (PDFPDF, 325 KB, April 2016)
  • Lyme Disease Case Investigation Form (PDFPDF, 74 KB, May 2015)
  • Malaria Case Investigation Form (PDFPDF, 118 KB, January 2016)
  • MDR-A Case Investigation Form (PDFPDF, 175 KB, January 2016)
  • Measles (Rash-Fever) Case Investigation Form (PDFPDF, 258 KB, November 2012)
    Measles Control Measure Tracking Form  (PDFPDF, 84 KB, December 2011)
  • Meningococcal (Neisseria Meningitidis) Case Investigation Form (PDFPDF, 181 KB, August 2016) 
  • Mumps Case Investigation Form (PDFPDF, 218 KB, September 2016) 
  • Paragonimiasis Case Investigation Form (PDFPDF, 96 KB, February 2016)
  • Pertussis Case Investigation Form (WORD, 115 KB, September 2016)
  • Pertussis Death Investigation Form, (PDFPDF, 32 KB, May 2007) 
  • Plague Case Investigation Form (PDFPDF, 67.0 KB, November 2004)
  • Q Fever Case Investigation Form (PDFPDF, 62.7 KB, August 2004)

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 R-W

  • Rash-Fever Illness Case Investigation Form (PDF, 258 KB, November 2012)
  • Respiratory Disease Contact Tracking Form (PDFPDF, 30 KB September 2011)
  • Respiratory Disease Outbreak Summary Form (PDFPDF, 319 KB, September 2011)
  • Rickettsial Disease Case Investigation Form  (PDFPDF, 94 KB, July 2017)
    Used for Anaplasmosis, Ehrlichiosis, Typhus, and Spotted Fever Group Rickettsiosis
  • Rubella (Rash-Fever) Case Investigation Form (PDFPDF, 258 KB, May 2008)
  • Smallpox Investigation Forms
    Evaluating Patients for Smallpox (PDFPDF)
    Post Event Surveillance Form (PDFPDF) 
  • Streptococcal Case Investigation Form (PDFPDF, 35 KB, July 2015) 
  • Taenia/Cysticercosis Case Investigation Form (PDFPDF, 53.4 KB, April 2007)
  • Tetanus Case Investigation Form (PDFPDF, 150 KB, May 2014)
  • Trichinosis Case Investigation Form (PDFPDF, 30 KB, June 2013)
  • Trichuriasis Case Investigation Form (PDFPDF, 30 KB, February 2016)
  • Tuberculosis Forms (See Reporting table.)
  • Tularemia Case Investigation Form (PDFPDF, 62.1 KB, August 2004)
    Tularemia Control Measure Tracking Form (PDFPDF, 20KB, December 2011)
  • Typhoid Fever Case Investigation eForm (PDFPDF, 86 KB, April 2009)
  • Varicella (Chickenpox)  Reporting Form  (PDFPDF, 34 KB, June 2012)
  • Varicella Death Investigation Form, (PDFPDF, 91 KB, May 2005)
  • Vibriosis Case Investigation Form, (PDF, 697 KB, June 2017) Guidance, (PDF, 697 KB, June 2017)           
  • VRSA/VISA Case Investigation Form (PDFPDF, 65 KB, January 2011)
  • Yersiniosis Case Investigation Form, 1998 revision (PDFPDF, 13 KB, May 2007)
  • Waterborne Disease Outbreak Reporting Form (PDFPDF, 87 KB, May 2008)
  • Zika Case Investigation Form (PDFPDF, 190 KB, May 2017)

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Last updated July 25, 2017