Forms for Waterborne Disease and Outbreak Reporting

LAUNCH ANNOUNCEMENT: NORS-Water officially launched on May 4, 2009. NORS users can contact their Reporting Site Administrators for information about the launch and the schedule for question and answer sessions being led by CDC.

The forms on this page are intended for use by waterborne disease outbreak coordinators at state and local health departments who complete waterborne disease and outbreak reports for submission to the Centers for Disease Control and Prevention (CDC). These forms are available in PDF format for completion by those health jurisdictions that do not have access to NORS and must therefore send a written report to their state NORS administrators. For guidance regarding the reporting process within a particular reporting site, users should contact their designated reporting site or agency administrators. Questions or feedback for CDC regarding NORS or the CDC 52.12 form may be directed to NORSadmin@cdc.gov.

State and local health departments have been reporting foodborne, enteric person-to-person and animal contact-associated outbreaks in NORS since February, 2009. The CDC 52.13 form for reporting foodborne, enteric person-to-person and animal contact-associated disease outbreaks and the Rules of Behavior form for NORS users can be accessed through CDC OutbreakNet – National Outbreak Reporting System (NORS).

NORS-Water Forms

• Guidance Document for NORS-Water  (PDF, 1.2 mb, 90 pages)

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• Complete NORS-Water Form (CDC 52.12 Form [Revised 03/2008])  (PDF, 255 kb, 14 pages)
• Recreational Water - Treated   (PDF, 176 kb, 6 pages)
• Recreational Water - Untreated   (PDF, 171 kb, 6 pages)
• Water Intended for Drinking (Drinking Water)  (PDF, 193 kb, 8 pages)
• Water Not Intended for Drinking or Water of Unknown Intent  (PDF, 172 kb, 6 pages)

Archived Reporting Forms

• CDC 52.12 Form (Revised 01/2003)  (PDF, 88 kb, 2 pages)

• Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.