Sexually transmitted disease report form 2025

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The document is a Confidential Sexually Transmitted Disease (STD)/HIV Report Form used by healthcare providers in Alaska to report cases of STDs and HIV. It includes sections for patient information, disease details, treatment information, and reporting instructions. The form is designed to facilitate the collection of essential data regarding STD/HIV diagnoses and treatments.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (151 Votes)
2016	4.3 Satisfied (223 Votes)
2014	4.9 Satisfied (49 Votes)

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What is the purpose of the Confidential STD/HIV Report Form?

The form is used by health care providers in Alaska to report cases of sexually transmitted diseases (STDs) and HIV.

Where can I find the Infectious Disease Report Form for other diseases?

You can find the Infectious Disease Report Form at http://www.epi.alaska.gov/pubs/conditions/crForms.htm.

What patient information is required on the form?

The form requires the patient's last name, first name, middle initial, date of birth, race, sex, physical address, and contact numbers.

How do I indicate if a patient is pregnant on the form?

You can indicate pregnancy status by checking 'Yes' and specifying the number of weeks or selecting 'No' or 'Unknown'.

What types of specimens can be reported for laboratory confirmation?

Specimens include urine, vaginal swab, urethral/cervical swab, pharyngeal swab, and rectal swab.

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How is a STD form?

The case report for Simplex is for initial genital infection. This diagnosis can be made by a clinician and cases should be reported with or without the presence of laboratory confirmation.

How does an STD get started?

They are spread mainly by sexual contact. STIs are caused by bacteria, viruses or parasites. A sexually transmitted infection may pass from person to person in blood, , or vaginal and other bodily fluids.

Which STD must be reported?

gonorrhea. hepatitis B (acute or chronic) HIV. syphilis.

What triggers an STD?

Sexually transmitted diseases are infections spread mainly by contact with genitals or bodily fluids. Also called STDs, STIs or venereal disease, sexually transmitted infections are caused by bacteria, viruses or parasites. Sexual activity includes genital touching or sexual intercourse.

How do STDs come around?

Most STIs pass from person to person by sexual contact through bodily fluids or from skin-to-skin contact by touching the infected part of a persons body, usually the genitals.

Sexually transmitted disease report form 2025

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Got questions?

What is the purpose of the Confidential STD/HIV Report Form?

Where can I find the Infectious Disease Report Form for other diseases?

What patient information is required on the form?

How do I indicate if a patient is pregnant on the form?

What types of specimens can be reported for laboratory confirmation?

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How is a STD form?

How does an STD get started?

Which STD must be reported?

What triggers an STD?

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