If you are a Brevard, Orange, Osceola or Seminole County Health Care Provider or Laboratory Director that diagnoses or treats HIV and AIDS patients, please be aware that Chapter 64D-3 of the Florida Administrative Code states that certain demographic and HIV and AIDS clinical information must be reported to your local county health department's HIV and AIDS Surveillance Office. You are required by Florida state law to report patients who are diagnosed with any of the following conditions:
HIV & AIDS reporting information is treated with the STRICTEST CONFIDENTIALITY. Do NOT fax any information pertaining to the reporting of HIV & AIDS cases.
Forms necessary to complete in order to officially report an HIV or AIDS case to the Orange County HIV and AIDS Surveillance Office:
One of the following case report forms must be completely filled out:
One of the following forms must be filled out by a physician:
The General Follow-up Form is for general follow-up on all the physician's HIV positive patients when tests results return HIV positive. The general follow-up form needs to be sent in only once to the health department if the physician chooses this follow-up choice.
The Individual Follow-up Form is for follow-up on each individual patient that tests HIV positive. This form needs to be sent to the health department each time a patient tests HIV positive, if the physician does not send a general follow-up form.
Follow-up Services by the Orange County Health Department entails:
How to send the forms to the Orange County Health Department:
Please print the forms. Answer all of the questions and place BOTH the HIV and AIDS Case Report and the Follow-up Form in an envelope marked CONFIDENTIAL with the name Scott Fryberger, Shonda Mitchell or Denise Caruthers and Orange County Health Department on it. Place that envelope inside another envelope and send it to:
Orange County Health Department
6101Lake Ellenor Dr.
Orlando, FL 32809