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Confidential Sexually Transmitted Disease (STD)/HIV Report Form State of Alaska, Section of Epidemiology Health care providers may use this form for making STD/HIV reports. Please use the Infectious.

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The Department of Public Health mandates reporting of 5 STDs; syphilis, gonorrhea, chlamydia, neonatal herpes, and chancroid. Surveillance activities are conducted on the 3 most common STDs; syphilis, gonorrhea, and chlamydia, all of which can be cured with proper treatment.

The STD 43 is a single page form to report newly diagnosed, re-infected, and treated STDs with the exception of HIV/AIDS. INSTRUCTIONS FOR COMPLETING the STD 43: Use one (1) form per person to report all applicable STDs. PLEASE Print legibly.

Reporting STDs by phone: • Call the NJ DHSS STD Program at (609)826-4869, and tell the staff person who answers your name, institution, and that you are calling to report an STD.

Reportable STIs are: Chlamydia (Chlamydia trachomatis) Gonorrhea (Neisseria gonorrhoeae) Syphilis (Treponema pallidum)

Any reportable infectious disease may be reported by phone to 651-201-5414 or 877-676-5414, or by filling out a confidential case report form.

Sexually transmitted diseases (STDs) — or sexually transmitted infections (STIs) — are generally acquired by sexual contact. The bacteria, viruses or parasites that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids.

Reportable STIs are: Chlamydia (Chlamydia trachomatis) Gonorrhea (Neisseria gonorrhoeae) Syphilis (Treponema pallidum)

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232