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Contact Us

350 Capitol Street
Room 125
Charleston, WV 25301
Phone: (304) 558-2195


Toll Free: (800) 642-8244

Disease Reporting

             HIPAA Privacy Letter on Disease Reporting

How are HIV/AIDS cases reported?

  • Cases are reported on the CDC HIV/AIDS Case Report form that is part of the reporting packet available from the surveillance staff.
  • The completed HIV/AIDS Case Report form is to be mailed directly to the HIV/AIDS Surveillance Program. 
                                       Attn: Vicki Hogan
                            Division of STD, HIV, and Hepatitis
                                 350 Capitol Street, Rm 125
                                     Charleston, WV 25301
  • The reporting packet contains a pre-addressed, postage paid envelope in which the case report can be mailed.
  • The surveillance staff is available upon request to come to a provider’s office to complete the CDC HIV/AIDS Case Report form.
  • It is required by law 64 CSR 64

            Adult HIV/AIDS Confidential Case Report
            Laboratory Report of Positive Tests for Human Immunodeficiency Virus (HIV)
            Pediatric HIV/AIDS Confidential Case Report
            HIV Test Form Part 1
            HIV Test Form Part 2
            HIV Testing Manual/Instructions

            Morbidity Card (VD-91)
            Laboratory Report of Reactive Tests for Syphilis
            Statement of Drugs Administered

            The Hepatitis B Vaccine: What You Need To Know
            WVSIIS Hepatitis Vaccine Project Data Form (Revised)
            Adult Viral Hepatitis B Immunization Initiative Project: On-Hand Report & Tally Sheet
            EXAMPLE On-Hand Report & Tally Sheet
            Vaccine Adverse Event Reporting System (VAERS) INSTRUCTIONS
            VAERS Reporting Form