The Confidential Communicable Disease Report Part 1 is the primary document used within the North Carolina Electronic Disease Surveillance System (NC EDSS) to track and respond to disease outbreaks across the state. Managed by the NC Department of Health and Human Services, Division of Public Health, Communicable Disease Branch, the form requires health care providers to submit clinical findings directly to their local health department.
The form collects comprehensive patient data including name, date of birth, address, race, and ethnicity, along with disease-specific details such as date of onset, symptoms, laboratory test results, and treatment received. Exposure information, including travel history, workplace settings, and known contacts, helps epidemiologists identify outbreak patterns and coordinate public health responses more effectively.
All information on the communicable disease report is confidential under North Carolina General Statute 130A-143 and exempt from standard public disclosure requirements. Healthcare providers, laboratories, and schools are required by state law to report specified communicable diseases within defined timeframes to protect community health throughout North Carolina.
| Question | Answer |
|---|---|
| Form Name | NC Communicable Disease Report Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | communicable disease form, communicable form, north carolina communicable disease form, nc communicable disease report, disease report form |