NEW YORK STATE DEPARTMENT OF HEALTH Infectious Diseases 2026

1. Click ‘Get Form’ to open the NEW YORK STATE DEPARTMENT OF HEALTH Infectious Diseases form in the editor.
2. Begin by filling out the Patient Demographics section. Enter the patient's last name, first name, middle initial, and date of birth. Ensure all required fields marked with an asterisk (*) are completed.
3. Provide the patient's address, telephone number, and race. Select the appropriate options for gender identity and ethnicity from the dropdown menus.
4. In the Specimen Information section, input the collection date and time. Specify the source of the specimen and any identifiers as needed.
5. Complete the Laboratory Examination Requested section by checking all relevant tests that apply to your submission.
6. Fill out Clinical History details including COVID-19 test status, relevant exposures, symptoms, and any hospitalization information.
7. Review all entered information for accuracy before submitting your form through our platform.

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