HIV/AIDS Reporting (For Providers)

Human Immunodeficiency Virus (HIV) infection at all stages is reportable by traceable mail, person-to-person transfer, or electronically within seven calendar days. Although laboratories report test results for patients, the medical provider is still required to submit a case report form in addition to the laboratory report. For complete HIV-specific reporting requirements, see Title 17, CCR, §2641.30-2643.20 and the California Department of Public Health’s HIV Surveillance and Case Reporting Resource page.

For HIV/AIDS Reporting, please contact the Surveillance Program Coordinator at (707) 565-4580.

* Do not fax HIV information to the health department *

Please review the following forms in order to prepare the information that will be requested by the Surveillance Program Coordinator.

Adult HIV/AIDS Case Report Form

Pediatric HIV/AIDS Case Report Form

California Department of Public Health, Office of AIDS