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Public Reportable Disease Form

2. 
4. Reno County Health Department Epidemiology Program
   209 W 2nd Ave | Hutchinson, KS 67501 | Tel: (620) 259-8450 | Fax: (620) 694-2905
6. Public Reportable Disease Form
8. ***If this is a medical emergency, please call 911.***
10. First Name*
11. Last Name*
12. Phone:*
14. Type of Illness:*
    -- Select One --Food illnessWater illnessAnimal BiteBug BiteInfectious diseaseOther
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17. Email address

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