Adult HIV/AIDS Confidential Case Report
download HIV/AIDS confidential case report form
California Law Requiring HIV Reporting By Name
On April 17, 2006, a new California law took effect, changing the way that HIV cases are reported. The new law requires that health care providers, laboratories, and local health departments report cases of HIV infection using patient names instead of coded identifiers. For more information about the new HIV reporting law, visit the California Department of Public Health, Office of AIDS website at www.cdph.ca.gov/AIDS.
For Health Care Providers Reporting An AIDS Diagnosis or a Case of HIV Infection
To report a case of HIV infection of AIDS, please complete the California Department of Public Health (CDPH) Adult HIV/AIDS Case Report Form (CDPH 8641A) available at www.cdph.ca.gov/programs/AIDS (click on “Forms” under Resources). Contact your local health department's HIV/AIDS surveillance program for information on how to fill out the form and where to send the completed form. The form must be sent to your local health department, not to CDHS. California law requires health care providers to submit HIV/AIDS case reports to the local health department within seven calendar days.
For copies of the case report form, information about how to submit case reports in a secure and confidential manner or for any other inquires about the reporting process, please contact your local health department's HIV/AIDS surveillance program. A list of authorized surveillance staff is available from the CDPH/Office of AIDS website at www.cdph.ca.gov/programs/AIDS (click on “Provider Resources” under Providers & Contractors).
