HIV/AIDS Confidential Case Report Forms
This form is used to report cases of HIV/AIDS in Minnesota residents to the Minnesota Department of Health.
On this page:
Form
Diseases to report on this form
Questions
Returning the completed forms
Order more forms
HIV/AIDS Confidential Case Report Form
The HIV reporting form has been updated. The form can be downloaded from this website as an interactive PDF file. You can fill it out and mail it to the Health Department.
Download the interactive print version of the forms:
Do not under any circumstances e-mail the completed form.
Diseases to report on this form
Questions
-
If you have questions regarding the HIV/AIDS Confidential
Case Report form, please call 651-201-5414.
- Submit only original forms to MDH - do not copy these forms.
- Do not use the yellow card (previously known as the "blue card") to report HIV/AIDS.
Returning the Completed HIV/AIDS Confidential Case Report Form
After filling out this form please mark the envelope "confidential" and return it to MDH:- by mail (please mark the envelope "confidential")
to:
Minnesota Department of Health
ATTN: HIV Surveillance Unit
Infectious Disease Epidemiology, Prevention and Control
625 North Robert Street
Post Office Box 64975
St. Paul, MN 55164-0975
- Do not under any circumstances e-mail the completed form.
Order more forms
- Download and print a version.
- To receive a copy of either form by mail please call 651-201-5414 or 877-676-5414 or use our on-line order form.
