New york universal reporting form 2026

The document is a Universal Reporting Form from the New York City Department of Health and Mental Hygiene, designed for reporting immediately notifiable diseases, outbreaks, and unusual disease manifestations. It provides detailed instructions on how to report various diseases, including contact information for the Provider Access Line and online reporting options. The form collects comprehensive patient information, including demographics, medical history, and details about the disease or condition being reported.

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Click ‘Get Form’ to open the New York Universal Reporting Form in the editor.
Begin by filling out the 'Patient Information' section. Enter the patient's last name, first name, middle name, date of report, and other personal details such as age and date of birth.
Complete the 'Guardian Information' if applicable. If the patient is a child, provide guardian details including their names and Medicaid number.
In the 'Medical History' section, indicate whether the patient has been hospitalized or is pregnant. Fill in any relevant dates for illness onset and diagnosis.
Proceed to specify any diseases or conditions by checking appropriate boxes in the 'Diseases and Conditions' section. Attach diagnostic laboratory results if available.
Finally, review all entries for accuracy before submitting. Use our platform's features to save your progress or share it directly with colleagues for collaboration.

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What STD has to be reported?

chlamydia. gonorrhea. hepatitis B (acute or chronic) .

Which NYC borough has the highest STD rate?

In New York City, call 1 (866) NYC-DOH1 (1-866-692-3641) for additional information. Health care personnel in New York City should use the downloadable Universal Reporting Form (PD-16) ; those belonging to NYC MED can complete and submit the form online .

Which diseases must be reported to the public health department?

Diseases reportable to the CDC include: Anthrax. Arboviral diseases (diseases caused by viruses spread by mosquitoes, sandflies, ticks, etc.) such as West Nile virus, eastern and western equine encephalitis. Babesiosis. Botulism. Brucellosis. Campylobacteriosis. Cancer. Candida auris, clinical.