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VISA/VRSA Case Report Form - Minnesota Dept. of Health

Vancomycin Intermediate and Vancomycin Resistant Staphylococcus aureus (VISA/VRSA) Case Report Form

There is also a supplemental reporting form for Vancomycin Intermediate and Vancomycin Resistant Staphylococcus aureus (VISA/VRSA).

Before filling out the VISA/VRSA Case Report Form, please call MDH at 651-201-5414 or 1-877-676-5414.

On this page:
VISA/VRSA Form
Frequently Asked Questions
Returning the Completed Form

VISA/VRSA Case Report Form

Frequently Asked Questions

  • Before filling out the VISA/VRSA Case Report Form, please call MDH at 651-201-5414 or 1-877-676-5414.

  • When reporting on a VISA/VRSA Case Report Form, a Yellow Card is not necessary.
    no yellow card

Returning the Completed VISA/VRSA Case Report Form

  • Please return the completed form to MDH:
    • By mail (please mark the envelope "confidential") to:
      Infectious Disease Epidemiology, Prevention and Control
      625 North Robert Street
      Post Office Box 64975
      St. Paul, MN 55164-0975
    • By fax to:
      1-800-233-1817

Diseases to report with this form

More about these diseases

Updated Friday, 14-Oct-2022 18:18:03 CDT