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Department of Health Services

Public Health Disease Control

HIV/AIDS Reporting


Medical providers, laboratories, hospitals and other facilities are required under Title 17, California Code of Regulations §2500 to report cases indicative of HIV or AIDS to the local health department within seven calendar days. Although laboratories report test results for patients, the medical provider is still required to submit a case report form in addition to the laboratory report. 

Download Forms

For HIV/AIDS Reporting, please contact the Surveillance Program Coordinator at (707) 565-4580.

Please review the following forms in order to prepare the information that will be requested by the Surveillance Program Coordinator.

Adult HIV/AIDS Case Report Form (PDF: 658 Kb)

Pediatric HIV/AIDS Case Report Form (PDF: 1.9 Mb)