Health care providers in Alaska use this 1-page fillable form to report infectious diseases, other than STDs and HIV, to the Section of Epidemiology. It records patient demographics and pregnancy, the disease name, specimen collection date, whether the diagnosis was laboratory confirmed, specimen and test type, and inpatient or outpatient status. The current version is marked Revised 10/2026.
The health care provider who diagnoses or suspects the condition, or facility staff reporting for them, completes the whole form, including the medical facility, attending provider and laboratory name if known.
Download the current version from the source each time; forms change without notice.
Confidential Infectious Disease Report Form
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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Yes. The Section of Epidemiology states that all health care providers and laboratories must report, and that when a condition is reportable by both, both parties must make a report. Point-of-care testers count as both provider and laboratory.
Call the Section of Epidemiology immediately rather than relying on this form; the form prints business-hours and after-hours numbers. The list of conditions classified as public health emergencies is on Alaska's Report a Health Condition page.