Resources & Forms

Perinatal Syphilis Monthly Report

To be completed monthly by Illinois hospital staff detailing the number of delivering people and syphilis documentation status.

CDPH Congenital Syphilis Case Report Form

The Chicago Department of Public Health's congenital syphilis case report form should be used for non-electronic reporting of cases.

Guide to Electronic Submission of Congenital Syphilis Case Reports to CDPH

The Chicago Department of Public Health features a comprehensive guide with instructions for how to electronically submit a congenital syphilis case report via their Chicago Health Information Management System (CHIMS).

IDPH STD Morbidity Report Form

The IDPH STD Morbidity Report Form should be completed and faxed to your local health department within seven days of disease diagnosis or treatment for presumed syphilis.