Hawaii's Department of Health requires physicians and other health care providers to report notifiable communicable diseases under Hawaii Administrative Rules Title 11, Chapter 156, and this two-page form is the written report. A clinician meets it after diagnosing, or provisionally diagnosing, a condition on the Exhibit A list. Page 1 is the report and page 2 lists the reportable diseases.
The health care provider who makes the diagnosis or provisional diagnosis completes page 1.
Download the current version from the source each time; forms change without notice.
Communicable Disease Report
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Tuberculosis, Hansen's disease, sexually transmitted diseases and AIDS/HIV. Page 2 of the form tells providers to report TB, AIDS/HIV and STDs directly to the TB Control, AIDS Surveillance and STD Prevention programs. Other conditions on the HAR Title 11, Chapter 156, Exhibit A list use this form.
Diseases flagged as urgent are phoned to the county DOH office first, and the written Communicable Disease Report follows within 3 days. After business hours, providers reach the Department of Health through the Physician's Exchange, which has an Oahu number and a toll-free number.
Yes. DOH posts a two-page fillable PDF, designated DOH/EPI 11/97, which can be typed and then printed for mailing or faxing to the county DOH office. Each county office, Oahu, Maui, Hawaii Island and Kauai, has its own contact details printed on the form.