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Reporting HIV/AIDS cases is vitally important to efforts to characterize the epidemic in Kentucky, gather resources for the fight against HIV/AIDS and maximize limited resources by directing assets to areas where they are likely to have the greatest impact. Funding for HIV-related medical services and treatment is directly related to the number of cases reported.   

How do I report a case?

Effective immediately, please report all cases by mail.

Please place case report forms inside two sealed envelopes, both marked Confidential, to the appropriate address below.

Please do not fax any confidential information.

For reports from Jefferson, Bullitt, Henry, Oldham, Spencer, Shelby and Trimble counties:

Reporting questions:
Sherita Hall or Aletia Smith
(502) 574-6574

Louisville Metro Public Health Department
Attn: Surveillance
400 E. Gray St.
Louisville, KY 40202

For reports from all other counties:

HIV/AIDS Case Reporting Questions Line:
Julie Kauzlarich, Ethan "Trey" Cardwell, Krista Mevoli,
Bethany Brown, Manny Singh, or Bob Ford
1 (866) 510-0008

Kentucky Department for Public Health
Attn: Surveillance
275 E. Main St., HS2E-C
Frankfort, KY 40621

The federal Centers for Disease Control and Prevention (CDC) Case Report Guidelines requires use of these forms to report HIV or AIDS cases (as described in
Kentucky 902 KAR 2:020, §13).  

Disclaimer: We cannot guarantee the accuracy or current status of CDC forms and other CDC resources linked on this page. For the most current guidelines/guidance and forms, please visit the CDC HIV Case Reporting and Surveillance web page.

Adult HIV Confidential Case Report Form
(Patients 13 or older at the time of diagnosis)

FILLABLE Adult Confidential Case Report Form
(Please Complete, Save, Print, and Mail to us at the above address)

Pediatric HIV Confidential Case Report Form
(Patients younger than 13 at the time of diagnosis)

FILLABLE Pediatric Confidential Case Report Form
(Please Complete, Save, Print, and Mail to us at the above address)

CDC HIV Surveillance Guidelines

Addressing HIPAA and Public Health Reporting (pdf, 63k)
HIPAA and the obligation of providers to report notifiable diseases

For assistance in determining a client's risk factor, please read 
CDC Technical Guidance for Risk Factor Ascertainment (pdf, 419k) 

Please refer to HIV/AIDS Resources for a complete list of KY HIV/AIDS legislation and regulations.