Severe Group A Streptococcus (GAS) Infection: Supplemental Form

This form is used to report all invasive cases of Group A Strep to the Minnesota Department of Health. This form is supplemental to the ABCs Case Report Form. Please return both forms to MDH.

On this page:
GAS form & instructions
Frequently asked questions
Returning the completed form
Diseases to report on this form

GAS form & instructions

• Severe Group A Streptococcus (GAS) Infection: Supplemental Form (PDF)
  Updated 2/2017
  • Severe Group A Streptococcus (GAS) Infection Form Instructions (PDF)
    Step-by-step instructions for filling out this form. Updated 7/2014
  • ABCs Case Report Form
    Please use both the Severe GAS form and the ABCs form when reporting invasive cases of Group A Strep .
    

Frequently asked questions

• If you have questions regarding these forms, please call 651-201-5414.
  
  
• When reporting on a Severe Group A Streptococcus (GAS) Infection Supplemental Form, a Yellow Card is not necessary
  

Returning the completed forms

• After filling out the Severe GAS Infection Supplemental Form, please fax it to 1-800-233-1817.

Diseases to report these forms

• Reporting Streptococcal Disease
  • Group A Streptococcus
    Exceptions: Group A Streptococcus is reportable from surgically obtained muscle. This is also reportable from any site (even non-sterile sites) in a case of toxic shock syndrome or necrotizing fasciitis.

More about this disease

• Group A Strep