California law requires health care providers to report by name suspected Acute HIV infections within 1 working day (by telephone) and to report cases of HIV infection and AIDS by name within 1 week.
Please download the complete CDPH Form 8641-A, Adult HIV/AIDS Confidential Case Report for reporting a case if a patient is > 13 years of age at time of diagnosis.
Instructions for completing the form: Instructions for completing Adult HIV/AIDS Case Report Form
Please download and complete DHS-8641-P, Pediatric HIV/AIDS Confidential Case Report for reporting a case if a patient is > 12 years of age at time of diagnosis.
If you like to report an HIV case or have any difficulty retrieving these files, please call Santa Clara County's HIV Surveillance teams confidential lines at (408) 792-3727 or (408) 792-3733. You can also send a completed form to confidential fax at (408) 792-3722.
Health care providers can mail case reports by using double envelopes and mail to:
STD/HIV Prevention & Control
Attention: HIV Surveillance
976 Lenzen Avenue
San Jose, CA 95126
Prompt reporting is critically important:
- To ensure linkage of care for any newly infected patients or continuation of care for previously diagnosed patients.
- To timely monitor current trends in the epidemic and to ensure proper funding for local HIV treatment and prevention services.
Please note that reporting HIV does not require patient consent and does not contradict
the Health Insurance Portability and Accountability ACT (HIPAA) Privacy Rule.