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Reporting Forms

Current CDC 52.12 Form - National Outbreak Reporting System (NORS)

  • Waterborne Disease Outbreaks (enteric, non-enteric)

Archived and Historical Forms for Reporting Waterborne Disease and Outbreaks Occurring from 1971–2008

The forms below are no longer valid or maintained and are provided for historical and research purposes only and as a service to the public health community. The information contained within these forms may no longer be current and/or accurate.

Historical Forms (1971–2008)

CDC 52.12 Forms (1981–2008)

2003-2008
1999
  • CDC 52.12 Form - Waterborne Diseases Outbreak Report (revised 1999) [PDF - 3 pages]
1996
  • CDC 52.12 Form (in color) - Waterborne Diseases Outbreak Report (revised 1996) [PDF - 3 pages]
  • CDC 52.12 Form (in greyscale) - Waterborne Diseases Outbreak Report (revised 1996) [PDF - 3 pages]
1991
  • CDC 52.12 Form - Waterborne Diseases Outbreak Report (revised 1991) [PDF - 3 pages]
1981
  • CDC 52.12 Form - Investigation of a Waterborne Outbreak (revised 1981) [PDF - 3 pages]

CDC 4.461 Forms (1975-1978)

1978
  • CDC 4.461 Form - Investigation of a Waterborne Outbreak (revised 1978) [PDF - 3 pages]
1975
  • CDC 4.461 Form - Investigation of a Waterborne Outbreak (revised 1975) [PDF - 3 pages]

CDC 4.245 Forms (1973-1974)

1974
  • CDC 4.245 Form - Investigation of a Foodborne Outbreak (revised 1974) [PDF - 3 pages]
1973
  • CDC 4.245 Form - Investigation of a Foodborne Outbreak (revised 1973) [PDF - 3 pages]

HSM 4.245 Forms (1969-1971)

1971
  • HSM 4.245 Form - Investigation of a Foodborne Outbreak (revised 1971) [PDF - 3 pages]
1969
  • HSM 4.245 Form - Investigation of a Foodborne Outbreak (revised 1969) [PDF - 3 pages]

* Some of the documents on this page, due to their historical nature, are not able to be provided in an accessible (508-compliant) format. Persons with disabilities experiencing problems accessing these documents should contact CDC-INFO at CDC-INFO@cdc.gov, 800-232-4636 or the TTY number at (888) 232-6348 and ask for a 508 Accommodation PR#9342. If emailing please type "508 Accommodation PR#9342" without quotes in the subject line of the email.

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