Pertussis Reporting Form

This form can be used to report pertussis (Bordetella pertussis - whooping cough) to the Minnesota Department of Health.

On this page:
Pertussis form
Frequently asked questions
Returning the completed form
Diseases to report on this form

How to report pertussis disease

• Online using the REDCap Vaccine Preventable Disease (VPD) Reporting Form.
  This form can be used by health care providers, schools and child care to report pertussis (whooping cough) to the Minnesota Department of Health.
   
• Any reportable infectious disease may be reported by phone to MDH at 651-201-5414 or 877-676-5414.

Frequently asked questions

• If you have questions regarding this form, please call 651-201-5414.
   
• When reporting on this form, a Yellow Card is not necessary.

Diseases to report with this form

• Reporting Pertussis (Bordatella pertussis)

More about this disease

• Pertussis (Bordetella pertussis - whooping cough)