ObjectiveTo develop an investigation form for hemodialysis infection outbreak, and to identify sources of outbreak in early stage. MethodsAfter an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 18 specialists. ResultsA total of 87 studies of hemodialysis infection outbreaks were eligible for inclusion. The mean authority coefficient (Cr) was 0.89. Kendall’s W coefficient of the specialist consultation was 0.359 after two rounds of consultation (p <0.005), suggesting that the specialists had similar opinions. Based on 4 primary items and 13 secondary items of the source of hemodialysis infection outbreak, and tripartite distribution characteristics of infected patients, we constructed the investigation form. ConclusionsThe investigation form can be used at the early stage of the cluster of cases, it’s a prerequisite for taking effective control measures, avoiding hemodialysis infection outbreak occurrence. However, the effect of the investigation form needs to be further evaluated.