HIV Case Reporting | Duval HIVCareNow

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HIV CASE REPORTING

Adult HIV Confidential Case Reporting Form (749 KB PDF)
(Patients ≥ 13 years of age at time of diagnosis)

Pediatric HIV Confidential Case Reporting Form (551 KB PDF)
(Patients < 13 years of age at time of diagnosis)

Please send completed reports in a double envelope marked “Confidential”

Mail completed form to:
Florida Department of Health in Duval County
Attention: HIV/AIDS Surveillance Office
921 North Davis Street
Bldg. A, Suite 251
Mail Code: 39
Jacksonville, FL 32209

All health care providers diagnosing and/or providing care to a patient with HIV are obligated to report using Florida HIV/AIDS Case Report. Case reports should be completed within fourteen (14) days after diagnosing or providing care to a patient with HIV/AIDS.