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HIV/AIDS Case Report Forms

Indiana Department of Health Confidential Case Report Forms

Do NOT fax case report forms. Completed case report forms should be mailed to:

Office of Clinical Data and Research
Indiana State Department of Health
2 North Meridian Street, 6-C
Indianapolis, IN 46204

Instructions for completing the Indiana HIV Case Report forms

These forms may be used any time but they are required on all reports made after January 15, 2013.

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