Get Ct Std-23 2020-2025

This guide provides step-by-step instructions on how to accurately complete the Connecticut STD-23 form online. Following these instructions will ensure proper reporting of sexually transmitted diseases as mandated by state regulations.

Follow the steps to complete the CT STD-23 form online.

1. Press the ‘Get Form’ button to access the STD-23 form and open it in your online PDF editor.
2. Begin by filling out the patient information section. Include the patient's last name, first name, middle initial, address, date of birth, and sex. Indicate if the patient is pregnant and specify the sex of their partners.
3. Complete the race and ethnicity sections, providing information about the patient's racial background and if they identify as Hispanic/Latino.
4. In the disease information section, select the specific sexually transmitted disease being reported. Indicate whether the patient is symptomatic or asymptomatic.
5. Fill out the treatment information section, including the treatment date and any prescribed antibiotics. Specify if expedited partner therapy was provided.
6. Provide information on the attending physician, including the name, address, phone number, and the date reported.
7. Review all fields for accuracy, make necessary adjustments, and ensure confidentiality by marking the envelope as ‘CONFIDENTIAL’ when mailing.
8. Once the form is completed, save your changes, and proceed to download, print, or share the form as needed.

Complete your CT STD-23 form online today for timely submission.