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HAHSTA Notifiable Disease Report Form

For questions regarding reporting of HIV, Viral Hepatitis, STD, and TB cases please contact us via phone at 202-671-4900 or via email at [email protected]

For questions regarding reporting Prevention Testing Program / publicly funded HIV, Viral Hepatitis and STD tests please contact HAHSTA via phone at 202-727-9858

PLEASE NOTE: Completed forms can be faxed to us at 202-673-4367. Due to the sensitive nature of the information, no forms can be submitted via email.

Reporting Forms:

  • HAHSTA Case Report Form for HIV/AIDS, Viral Hepatitis, STD's, and Tuberculosis
    • HAHSTA Provider Portal; Assistance in submitting a case report ​​​
    • Tuberculosis Case Reporting: Providers must submit a case report to the DC TB Program for a confirmed or suspected case of active TB within 48 hours of suspicion, diagnosis, or the appearance of symptoms. This applies to any patient that resides in DC.
      TB suspicion/diagnosis for the purposes of reporting is defined by the first of: a positive AFB smear collected, a positive MTBC culture, a positive NAAT for MTBC, or clinical diagnosis/suspicion of active tuberculosis.
      To submit a TB Case Report, you may use the electronic reporting system (preferred), or you may fax the TB Case Report Form to 202-724-2363, Attn: New TB Case/ Suspect

      When sending either report please include:
      • the formal TB Case Report Form
      • laboratory results or collections (NAAT, AFB smears, cultures, IGRAs, TSTs)
      • Radiology results (CXR, etc).
      • the medical record/hospital admission note
    • For a step-by step guide to completing the
      reporting fields please click here.

Laboratories are required to report all positive Mycobacterium tuberculosis complex results whenever determined by culture, NAAT, or otherwise, for DC residents.


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