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HIV/AIDS Case Reporting Forms 

CDPH 8532

Request for HIV/AIDS Summary Data *Due to staffing shortages at the Office of AIDS, please allow 60 days for completion of data requests.

CDPH 8641 A (Instructions)

Adult HIV/AIDS Case Report Form (ACRF)

CDPH 8641 P

Pediatric HIV/AIDS Case Report Form (PCRF)

CDPH 8681

HIV Testing and Antiretroviral Use History (Note: For adult cases, this form has been integrated into the ACRF, CDPH 8641 A)

CDPH 8689

HIV/AIDS Confidentiality Agreement

CDPH 8713

California HIV/AIDS Case Reporting System Data Use and Disclosure Agreement

AIDS Forms Home

Last modified on: 4/16/2015 8:11 AM