HIV CASE REPORTING
- Adult HIV Case Report Form (confidential) - Patients younger than 13 years of age at time of diagnosis
- Pediatric HIV Confidential Case Reporting Form (confidential) - Patients older than 13 years of age at time of diagnosis
All health care providers diagnosing and/or providing care to a patient with HIV are obligated to report using Florida HIV/AIDS Case Report. Case reports should be completed within 14 days after diagnosis, or providing care to a patient with HIV/AIDS.
Case reports can be sent by:
Mail
Florida Department of Health in Duval County
Attention: HIV/AIDS Surveillance Office
921 North Davis St., Bldg. A, Suite 251, Mail Code: 39
Jacksonville, FL 32209
Please send completed reports through traceable mail in a double envelope marked “CONFIDENTIAL."
Fax
904-253-2600
Include a cover sheet indicating “CONFIDENTIAL” and include the following paragraph for all confidential transmissions:
“This transmission may contain material that is CONFIDENTIAL under federal law and Florida Statutes and is intended only for the named addressee. Unauthorized use of this information may be a violation of criminal statutes. If this information is received by anyone other than the named addressee, the recipient must immediately notify the sender at the address or telephone number above and obtain instructions on disposal. Under no circumstances should this material be shared, retained, or copied by anyone other than the named addressee.”
Email
Confidential information must be encrypted during transmission over any network not owned by the Florida Department of Health. Send encrypted email to Area4.HIVSurveillance@flhealth.gov.
