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Procedures for STD Reporting

In addition to the laboratory reporting to the State Department of Health, it is also the clinician’s responsibility to report sexually transmitted diseases to the State. However, according to HIPAA this reporting constitutes an “unauthorized disclosure” and must be documented. The STDs that need to be reported include syphilis, gonorrhea, Chlamydia, primary genital herpes, chancroid, LGV, and granuloma inguinale.

Reporting an STD is a TWO STEP procedure. Each step can be accomplished in 1 of 2 ways.

Step 1: Reporting the STD (must be done within 3 days of diagnosis)

Fill out the "Sexually Transmitted Disease Confidential Case Report" and either mail to the STD clinic (address on the form); the form be found in the first drawer of the forms cabinet in the provider room.

Option to fax the STD CCR [pdf] form to 744-5622

Step 2: Reporting the “Unauthorized Disclosure”

A) Link - and follow the instructions.


B) Fill out the “HIPAA Form for STD/AIDS Reporting” and give to the front desk to process; this form can be found in the second drawer of the forms cabinet in the provider room

For questions regarding this procedure, please contact Dr. Jeff Schouten.

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