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Contact Info
Infectious Disease Epidemiology, Prevention and Control Division
651-201-5414
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
- Vancomycin Intermediate and Vancomycin Resistant Staphylococcus aureus (VISA/VRSA) Case Report Form (PDF)
Updated 10/2015
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.
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
- By mail (please mark the envelope "confidential") to:
Diseases to report with this form
More about these diseases
Last Updated: 10/20/2022