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.
These form can be downloaded from this website as interactive PDF files. You can fill them out and mail them to the Health Department.
Download the interactive print version of the forms:
Do not under any circumstances e-mail the completed form.
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.
- by mail (please mark the envelope "confidential")
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.