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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 publicly funded HIV, Viral Hepatitis, STD, and TB tests please contact us via phone at 202-671-5055. 

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 notes

        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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