Conditions Reportable to Public Health in Alaska: Report Forms

To report Public Health Emergencies call (907) 269-8000
or after hours (800) 478-0084

Report Forms

• Infectious Disease Report Form  (37 KB)
• Blood Lead Level Reporting Form  (37 KB)
• Firearm Injury Reporting Form  (36 KB)
• ACR Cancer Reporting Form for Health Care Providers  (87 KB)
• Birth Defects Reporting Form  (36 KB)

Section of Epidemiology Assistance

For most conditions, the basic information requested on the applicable report form is all that is necessary for reporting. For some situations, an epidemiologist will contact the reporting health care provider to discuss the case and obtain additional information.

Further assistance may be obtained by calling the Section of Epidemiology at 1-907-269-8000. Available assistance includes:

• Epidemiologic investigation.
• Infectious disease consultation.
• Consultation on diseases related to occupational or environmental exposure to a toxic or hazardous substance.
• Partner counseling and referral services for patients with a sexually transmitted disease, including AIDS or human immunodeficiency virus (HIV) infection.
• Information on and assistance in obtaining diagnostic laboratory tests.
• Information on and assistance with electronic reporting by modem, computer disk, or other media.

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