Office of Communicable Diseases

Information for Health Care Providers

REPORT FORMS TO USE WHEN REPORTING A DISEASE TO HEALTH

A.   Choose the appropriate form below and print out a copy to complete:

• To report most diseases use:
  Reportable Disease Confidential Case Report Form
• To report Lyme Disease use:
  Lyme Disease Confidential Case Report form
• For HIV/AIDS and STD: A copy of the forms for HIV/AIDS and the STDs can be obtained by calling (401) 222-2577.
• Rabies Bite Case Report
• TB Report form
• Varicella Case Report Form

OR

B.   Complete the Form online

• Reportable Disease Confidential Case Report Form
• Online instructions for completing the form:

C.   Mail or fax the appropriate form to:

RI Department Of Health
Office of Communicable Diseases
3 Capitol Hill – Room 106
Providence, RI  02908-5097
(401) 222-2488 (fax)