Use this online form to submit reportable diseases/conditions to the Alabama Department of Public Health. All required fields are marked with a red asterisk (*); it is not possible to submit the report without completing all required fields. Complete the other fields when known. Public Health will follow-up with the reporter for the patient demographics and lab report, if missing.
If you are a laboratorian, reporting on behalf of a laboratory, blood bank, or plasma center, the REPORT Card is not the mechanism you should use to report a patient that has a reportable disease or health condition. Please email firstname.lastname@example.org to learn more.
For all other reporters, please complete the requested information below.