Idph std reporting form 2026

1. Click ‘Get Form’ to open the idph std reporting form in the editor.
2. Begin by filling out the 'Patient Information' section. Ensure you print firmly and neatly, using dark ink only. Enter the patient's first name, middle initial, last name, and contact details accurately.
3. Indicate if expedited partner therapy was given for chlamydia or gonorrhea by selecting 'Yes', 'No', or 'Unknown'. If applicable, specify how many partners were treated.
4. Complete the diagnosis section by marking all relevant STDs diagnosed. Be sure to fill in circles completely and avoid any mistakes; if you make one, mark it clearly as instructed.
5. In the treatment information section, provide details about the treatment received, including dates and Rx codes from the provided list. This ensures accurate reporting of care provided.
6. Finally, review all entries for accuracy before submitting. Once completed, send the original form to your local health department as specified.

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