Interstate Communication Control Record (ICCR) · 2008. 10. 27. · Interstate Communication ....

Interstate Communication Control Record (ICCR)

A Comprehensive STD Project Area Guide to Assist in the Movement of Patient Records between Public Health

Jurisdictions

Compiled by Susan O’Bryan MLIS

Florida Department of Health Bureau of STD Prevention and Control

Alabama State of Alabama Communicable Diseases 201 Monroe St Ste 110 Montgomery, AL 36104-3721 Phone number - 334-206-5350 Fax Number – 334-206-2768 HIV phone number - 334-206-5325 Contact name – Dorothy Easterl HIV - Tonya Snider Diseases accepted Chlamydia – less than 2 months from the date of the specimen. Gonorrhea – less than 2 months from the date of the specimen

Syphilis HIV – include exposure dates

Return of dispositions Chlamydia – None Gonorrhea – None

Syphilis - 2 weeks from notification HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab results, then administratively close our field record. Contacts – Fax the lab results and administratively close our field record. Gonorrhea Positive lab results – Mail the lab results, then administratively close our field record. Contacts – Fax the lab results and administratively close our field record. Syphilis Positive lab results – Mail the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition. HIV Positive lab results – Mail the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition.

Alaska State of Alaska Dept of Health Section of Epidemiology 3601 “C” Street Ste 540 Anchorage, AK 99503 Phone number – 907-269-8063 (Terry Schanhals) Fax Number – 907-561-4239 HIV phone number – 907-269-8057 (Melissa Boyette) Contact name – Terry Schanhals HIV - Melissa Boyette Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – on completion of investigation. Gonorrhea – on completion of investigation.

Syphilis – on completion of investigation. HIV – on completion of investigation.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax in and wait on disposition. Contacts – Fax in and wait on disposition. Gonorrhea Positive lab results – Fax in and wait on disposition. Contacts – Fax in and wait on disposition. Syphilis Positive lab results – Phone in and then fax the lab results, wait on the disposition Contacts – Phone in and then fax the lab results, wait on the disposition. HIV Positive lab results – Phone in and then fax the lab results, wait on the disposition Contacts – Phone in and then fax the lab results, wait on the disposition.

Arizona Arizona Dept. of Health Service STD Program 150 N 18th Ave Ste 140 Phoenix, AZ 85007-3237 Phone number – 602-364-4666 Fax Number – 602-364-2119 HIV phone number - 602-364-3612 Contact name – Keith Scaggs (Syphilis) Linda Ripley (CT and GC) HIV - Linda Diaz Diseases accepted - Chlamydia Gonorrhea


Return of dispositions – Chlamydia – 2 weeks from notification Gonorrhea – 2 weeks from notification


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the lab results, then wait on a disposition. Contacts – Fax the lab results, then wait on a disposition. Gonorrhea Positive lab results – Fax the lab results, then wait on a disposition. Contacts – Fax the lab results, then wait on a disposition. Syphilis Positive lab results – Mail the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition. HIV Positive lab results – Call the lab results, wait on the disposition Contacts – Call the lab results, wait on the disposition.

Arkansas Arkansas Dept. of Health Division of AIDS / HIV 4815 W Markham St Mail slot # 33 Little Rock, AR 72205-3867 Phone number – 501-280-4036 Fax Number – 501-661-2035 HIV phone number - Same Contact name – Marie Wilson - P1’s to Syphilis and HIV Keevan Murphy – Positives for Syphilis and HIV Jawaski Fisher - Chlamydia Katherine Zoch – Gonorrhea Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the lab results, then call for a disposition. Contacts – Fax the lab results, then call for a disposition. Gonorrhea Positive lab results – Fax the lab results, then call for a disposition.. Contacts – Fax the lab results, then call for a disposition. Syphilis Positive lab results – Fax the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition. HIV Positive lab results – Mail the lab results, wait on the disposition Contacts – Call the lab results, wait on the disposition.

California – Sacramento (1 of 3) Department of Health Services STD Control Branch MS7320 PO Box 2230 Sacramento, CA 95812-2230 Phone number – 916-552-9799 Fax Number – 916-552-8974 HIV phone number – 916-449-5867 Contact name – Berlene Osafo-Mensah HIV - Susan Chapman – Record Searches for HIV Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV – NONE (Report to Office of AIDS In CA at 916-445-0553)

Return of dispositions – Chlamydia – Gonorrhea –

Syphilis - 2 weeks from notification HIV - NONE

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Faxed unless pregnant or women under 39 years of age, which is called. Contacts – Faxed unless pregnant or women under 39 years of age, which is called. Gonorrhea Positive lab results – Faxed unless pregnant or women under 39 years of age, which is called. Contacts – Faxed unless pregnant or women under 39 years of age, which is called. Syphilis Positive lab results – Faxed unless pregnant or women under 39 years of age, which is called. Contacts - Faxed unless pregnant or women under 39 years of age, which is called. HIV Positive lab results - NONE Contacts - NONE

California – San Francisco (2 of 3) San Francisco Department of Public Health City Clinics / STD Prevention and Control 356 7th St San Francisco, CA 94103 Phone number – 415-487-5524 Fax Number – 415-431-4628 HIV phone number – Contact name – Monica Lee HIV - Susan Chapman Diseases accepted - Chlamydia – Positives only. Gonorrhea – Positives only.

Syphilis – Positives and contacts to 710, 720, 730. HIV – Positives and contacts

Return of dispositions – Chlamydia - 2 weeks from notification Gonorrhea - 2 weeks from notification

Syphilis - 2 weeks from notification HIV - 1 month from notification

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call in information, wait on disposition Contacts – None Gonorrhea Positive lab results – Call in information, wait on disposition Contacts – None Syphilis Positive lab results – Call in information, wait on disposition Contacts – Call in information, wait on disposition HIV Positive lab results – Call in information, wait on disposition Contacts – Call in information, wait on disposition

California – Los Angeles (3 of 3) Department of Public Health STD Program 2615 S Grand Ave, Room 500 Los Angeles, CA 90007-2608 Fax Number – 213-741-9245 (all referrals) Contact name – Tracey Smith Phone number – 213-744-3342 Em: [email protected] HIV contact - Michael Granado HIV contact phone – 213-744-3338 Em: [email protected] Diseases accepted Chlamydia –Yes. Reactors age 25 & younger may receive priority. Gonorrhea –Yes. Reactors age 25 & younger may receive priority.

Syphilis - Yes. Sex partners need description if only locating information is phone #. HIV -Yes

Return of dispositions Chlamydia – When requested in advance only.

Gonorrhea – When requested in advance only. Syphilis -- By phone or FAX, 14 days after receipt. Reactor dispositions must be

requested. HIV – By phone or FAX, 14 days after receipt.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – By FAX or mail. Dispositions provided only when requested in advance. Contacts – By FAX or mail, FAX preferred. Dispositions provided only when requested in advance. Gonorrhea Positive lab results – By FAX or mail. Dispositions provided only when requested in advance. Contacts – By FAX or mail. Dispositions provided only when requested in advance. Syphilis Positive lab results – By FAX or mail, mail preferred. Contacts – By FAX or phone, FAX preferred. HIV Positive lab results – By FAX or mail, mail preferred. Contacts -- By FAX or phone, FAX preferred.

mailto:[email protected]

mailto:[email protected]

Colorado Colorado Dept of Public Health & Environment STD Registry DCEED-STD-A3 4300 Cherry Creek Dr South Denver, CO 80246-1530 Phone number – 303-692-2694 Nedra Freeman 303 692 2697 Lupe Cordova Fax Number – 303-782-5393 HIV phone number – 303-692-2697 Contact name – Nedra Freeman HIV - Lupe Cordova Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – If requested Gonorrhea – If requested

Syphilis - 2 weeks from notification for contacts. HIV - 1 month from the time of notification for contacts.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, fax or mail information, wait on or call for disposition. Contacts – Call, fax or mail information, wait on or call for disposition. Gonorrhea Positive lab results – Call, fax or mail information, wait on or call for disposition. Contacts – Call, fax or mail information, wait on or call for disposition. Syphilis Positive lab results – Call, fax or mail information, wait on or call for disposition. Contacts – Call, fax or mail information, wait on or call for disposition. HIV Positive lab results – Call, fax or mail information, wait on or call for disposition. Contacts – Call, fax or mail information, wait on or call for disposition.

Connecticut State of Connecticut Diseases 410 Capitol Ave Hartford, CT 06106-1367 Phone number - 860-509-7920 Fax Number – Contact name – Penny Lane

Angela Foster Diseases accepted - Chlamydia – less than 2 months from the date of the specimen. Gonorrhea – less than 2 months from the date of the specimen

Syphilis HIV

Return of dispositions – Chlamydia Gonorrhea


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the lab result, then wait on disposition. Contact – Fax the lab result, then wait on disposition. Gonorrhea Positive lab results – Fax the lab result, then wait on disposition. Contact – Fax the lab result, then wait on disposition. Syphilis Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition. HIV Positive lab results – Fax the lab result, then wait on disposition. Contacts– Fax the lab result, then wait on disposition.

Delaware State of Delaware Division of Public Health STD Program 417 Federal Street Dover, DE 19901 Phone number – 302-744-1025 Fax Number – 302-739-2548 HIV phone number – 302-744-1015 Contact name – Sheri Swackhammer (also contacts to HIV) HIV - Christina Melvin Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification, in most cases, by phone. Gonorrhea – 2 weeks from notification, in most cases, by phone.

Syphilis - 2 weeks from notification, by phone. HIV - 2 weeks from notification, by phone.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call in the lab information, wait on disposition, if requested. Contacts – Call in the lab information, wait on disposition, if requested. Gonorrhea Positive lab results – Call in the lab information, wait on disposition, if requested. Contacts – Call in the lab information, wait on disposition, if requested. Syphilis Positive lab results – Call in the lab information, wait on disposition. Contacts – Call in the lab information, wait on disposition. HIV Positive lab results – Call in the lab information, wait on disposition. Contacts – Call in the lab information, wait on disposition.

Florida Florida Dept of Health 2585 Merchants Row Blvd Bin A-19 Tallahassee, FL 32311 Phone number – 850-245-4325 850-245-4444 ex 2344 (Valerie) 850-245-4601 Fax Number – 850-414-8103 HIV phone number – same as above Contact name – Kasey Strickland Valerie Ellis Susan O’Bryan HIV - same as above Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – If requested. Gonorrhea – If requested.

Syphilis - If requested. HIV - If requested.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. Gonorrhea Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. Syphilis Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. HIV Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax.

Georgia Georgia Dept of Health ATTN STD Branch (OR ATTN HIV Branch) 2 Peachtree St NW 12th Floor Atlanta, GA 30303 Phone number – 404-657-9990 Fax Number – 404-657-7365 HIV phone number – 404-463-2440 Contact name – Sonji Casterlow HIV - Diseases accepted - Chlamydia – less than 1 year from the date of specimen Gonorrhea – less than 1 year from the date of specimen

Syphilis – less than 1 year from the date of specimen, unless spousal notification, in this case up to 10 years from the date of specimen. HIV – less than 1 year from the date of specimen, unless spousal notification, in this case

up to 10 years from the date of specimen. Return of dispositions – Chlamydia – None Gonorrhea – None

Syphilis - 2 weeks from notification for contacts. On request for positives. HIV - 1 month from the time of notification for contacts. On request for positives.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the FR unless pregnant, then administratively close our field record. Pregnant women, call in. Contacts – Mail the FR unless pregnant, then administratively close our field record. Pregnant women, call in. Gonorrhea Positive lab results – Mail the FR unless pregnant, then administratively close our field record. Pregnant women, call in. Contacts – Mail the FR unless pregnant, then administratively close our field record. Pregnant women, call in. Syphilis Positive lab results – Mail the lab results for titers < 16, call in titers > 16 or pregnant women, wait on the disposition, when requested. Contacts – Mail the lab results for titers < 16, call in titers > 16 or pregnant women, wait on the disposition HIV Positive lab results – mail the lab results, wait on the disposition, when requested. Contacts – fax the lab results, wait on the disposition.

Hawaii State of Hawaii Dept of Health STD / AIDS Prevention Branch 3627 Kilauea Ave Room 304 Honolulu, HI 96816 Phone number – 808-733-9289 Fax Number – 808-733-9291 HIV phone number Contact name – Judy Ouchi HIV - Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – By mail or phone if requested. Gonorrhea – By mail or phone if requested.

Syphilis - 2 weeks from notification. By mail or phone if requested. HIV - 1 month from the time of notification. By mail or phone if requested.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition. Gonorrhea Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition. Syphilis Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition. HIV Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition.

Idaho Idaho Dept of Health 450 W State St, 4th Floor PO Box 83120 Boise, ID 83702 Phone number – 208-334-5939 Fax Number – 208-332-7307 HIV phone number – same as above Contact name – Jared Bartschi, Rhonda Jones HIV - same as above Diseases accepted Chlamydia – less than 2 months from the date of the specimen. Gonorrhea –

Syphilis - HIV –

Return of dispositions Chlamydia – If requested Gonorrhea – If requested

Syphilis - If requested HIV - If requested

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. Gonorrhea Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. Syphilis Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax. HIV Positive lab results – Call, mail, or fax. Contacts – Call, mail, or fax.

Illinois – (1 of 2) Illinois Department of Public Health; STD Section 525 W Jefferson St Springfield, Il 62761 Phone number – 217-782-2747 Fax Number – 217-524-5443 State of Illinois HIV 525 W Jefferson St 1st Floor Springfield, Il 62761 HIV phone number – 217-524-5983 – Christine Lefler-Miller 217-524-3675 - Carole Keiller Contact name – John Creviston – Positive labs John Krevastan - Positive labs, partners and clusters Valerie Young HIV - Christine Lefler-Miller – (Positives) Carole Keiller (Contacts) Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – None. Gonorrhea – None.

Syphilis - 2 weeks from date of notification, partners only. HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab results, administratively close field record. Contacts – Fax the lab results, then wait for disposition. Gonorrhea Positive lab results – Mail the lab results, administratively close field record. Contacts – Mail the lab results, administratively close field record. Syphilis Positive lab results – Fax or call in the lab results, administratively close field record. Contacts – Fax or call in the lab results, wait on the disposition. HIV Positive lab results – Mail the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition.

Illinois – Chicago (2 of 2) Chicago Dept of Health STD Surveillance Unit 530 E 31st St Chicago, Il 60616 Phone number – 312-413-8033 Fax Number – 312-747-0110 HIV phone number – 217-557-3676 Contact name – Gus Conda HIV - Send to state office HIV Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV


Syphilis - 2 weeks from date of notification HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results on an OP – Fax the field record and administratively close it. Positive lab results on a contact – Fax the field record and administratively close it.. Gonorrhea Positive lab results – Fax the field record and administratively close it.. Contacts – Fax the field record and administratively close it. Syphilis Positive lab results – Fax the field record and lab results, wait on the disposition Contacts – Fax the field record and lab results, wait on the disposition HIV Positive lab results – Mail the lab results, wait on the disposition Contacts – Fax the lab results, wait on the disposition.

Indiana Indiana State Department of Health HIV / STD Division - STD Program 2 N Meridian, Section 6C - 23 Indianapolis, IN 46204-3006 Phone number – 317-233-8208 (Katherine) 317-234-2871 (Dawne) Fax Number – 317-234-0144 HIV phone number – Same Contact name – Katherine Browne Dawne Rekas Diseases accepted Chlamydia Gonorrhea

Syphilis HIV – Contacts only.

Return of dispositions Chlamydia – 2 weeks from notification for positives, upon request for contacts. Gonorrhea – 2 weeks from notification for positives, upon request for contacts.

Syphilis - 2 weeks from notification. HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia

Positive lab results – Fax or call the field record and lab results, call or fax request for disposition. Contacts – Fax or call the field record and lab results, call or fax request for disposition. Gonorrhea

Positive lab results – Fax or call the field record and lab results, call or fax request for disposition. Contacts – Fax or call the field record and lab results, call or fax request for disposition.

Syphilis Positive lab results – Fax or call the field record and lab results, call or fax request for disposition. Contacts – Fax or call the field record and lab results, call or fax request for disposition. HIV Positive lab results – None. Contacts – Fax or call the field record and lab results, call or fax request for disposition

Iowa Iowa Department of Health Bureau of Disease Prevention ‘OO’ 321 E 12th St Des Moines, IA 50319-0075-3 Phone number – 515-281-3131 3031 Fax Number – Fax is not confidential HIV phone number – 515-281-6918 STD’s and HIV partners – Anna Bode HIV Search - Robert Worker Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – None Gonorrhea – None

Syphilis - 2 3 weeks from notification HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia

Positive lab results – Mail the field record and lab results, then administratively close our field record.

Contacts – Mail the field record and lab results, then administratively close our field record. Gonorrhea

Positive lab results – Mail the field record and lab results, then administratively close our field record.

Contacts – Mail the field record and lab results, then administratively close our field record. Syphilis Positive lab results – Call the lab results, wait on the disposition Contacts – Call the lab results, wait on the disposition. HIV Positive lab results – Call the lab results, wait on the disposition Contacts – Call the lab results, wait on the disposition.

Kansas Kansas Department of Health and Environment Bureau of Disease Control and Prevention 1000 SW Jackson Ste 210 Topeka, KS 66612 Phone number – 785-296-5596 (Stephanie) 785-296-5595 (Zella) Fax Number – 785-296-5590 HIV phone number – 785-296-5597 Fax Number – 785-296-4197 Contact name – Stephanie Green (GC, CT Syphilis and HIC partners) Zella Lawton (GC, CT Syphilis and HIC partners) HIV - Terry McAdam – HIV positives Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia- 2 weeks from date of notification Gonorrhea - 2 weeks from date of notification


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Faxed, then call for disposition. Contacts – Faxed, then call for disposition. Gonorrhea Positive lab results – Faxed, then call for disposition. Contacts – Faxed, then call for disposition. Syphilis Positive lab results – Faxed, then call for disposition

Contacts – Faxed, then call for disposition HIV Positive lab results – Faxed, then call for disposition Contacts – Faxed, then call for disposition.

Kentucky CHFS-DPH STD Program 275 E Main St Mail Stop HS2C-C Frankfort, KY 40601 Phone number – 502-564-7818 Ex 3542 Fax Number – 502-564-5717 HIV phone number – Contact name – Melinda Stephens HIV - Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia - None Gonorrhea - None


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mailed, administratively close our field record. Contacts – Mailed, then administratively close our field record. Gonorrhea Positive lab results – Mailed, administratively close our field record. Contacts – Mailed, then administratively close our field record. Syphilis Positive lab results – Fax or call in the lab results, administratively close our field record.

Contacts – Fax or call in the lab results, wait on the disposition. HIV Positive lab results – mail the lab results, administratively close our field record. Contacts – fax the lab results, wait on the disposition.

Louisiana Dept of Health STD Program PO Box 60630 2nd Floor New Orleans, LA 70160 Phone number – 504-219-4429 Fax Number Contact name – Madeline Bierra Diseases accepted Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab results, then administratively close our field record. Contacts – Mail the lab results, then administratively close field record. Gonorrhea Positive lab results – Mail the lab results, then administratively close our field record. Contacts – mail the lab results, then administratively close our field record. Syphilis Positive lab results – Call with the lab result, then wait on disposition. Contacts – Call with the lab result, then wait on disposition.. HIV Positive lab results – Call the lab result, then wait on disposition. Contacts – Call the lab results, wait on the disposition.

Maine Maine Dept of Health HIV / STD / Viral Hepatitis 286 Water St 9th Floor Augusta, ME 04333 Phone number – 207-287-2046 (Ann) 207-287-5542 (Kerrie) Fax Number – 207-287-3498 HIV phone number – same as above Contact name – Ann Wheeler Kerrie Lall Diseases accepted - Chlamydia Gonorrhea




HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the field record, then wait on a disposition. Contacts – Fax the field record, then wait on a disposition. Gonorrhea Positive lab results – Fax the field record, then wait on a disposition. Contacts – Fax the field record, then wait on a disposition. Syphilis Positive lab results – Fax the field record, then wait on a disposition. Contacts – Fax the field record, then wait on a disposition. HIV Positive lab results – Fax the field record, then wait on a disposition. Contacts – Fax the field record, then wait on a disposition.

Maryland (1 of 2) Dept of Health STD Control 201 W Preston St Room 307 B Baltimore, MD 20201 Phone number - 410-767-6689 Fax Number – 410-333-5529 Maryland AIDS Administration 500 N Calvert St 5th Floor Baltimore, MD 20202 HIV phone number – 410-767-5372 – Marilyn Walkins 410-767-5023 – Mohammed Haque Contact name – Chlamydia and gonorrhea - Ann McDonald 700 contacts - Crystal Johnson 700 reactors – Judy Hilnbrand HIV – Diseases accepted - Chlamydia – less than 2 months from the date of the specimen. Chlamydia – less than 2 months from the date of the specimen

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification – include request for disposition. Gonorrhea – 2 weeks from notification – include request for disposition.


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition. Gonorrhea Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition. Syphilis Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition.. HIV Positive lab results – Call in the lab result, then wait on disposition. Ccontacts – Call in the lab results, wait on the disposition.

Maryland – City of Baltimore (2 of 2) Dept of Health STD Control 201 W Preston St Room 307 B Baltimore, MD 20201 Phone number - 410-396-4448 Fax Number – 410-333-5529 Contact name – Grace Lacy Diseases accepted - Chlamydia – less than 2 months from the date of the specimen. Gonorrhea – less than 2 months from the date of the specimen

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition. Gonorrhea Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition. Syphilis Positive lab results – Fax the lab result, then wait on disposition. Contacts – Fax the lab result, then wait on disposition.. HIV Positive lab results – Call in the lab result, then wait on disposition. Contacts – Call in the lab results, wait on the disposition.

Massachusetts Massachusetts Dept of Health 305 South St Boston, MA 02130 Phone number – 617-983-6954 Fax Number – 617-983-6962 HIV phone number Contact name – Norma Hylton Diseases accepted - Chlamydia – Contacts and positives without treatment. Gonorrhea – Contacts and positives without treatment.

Syphilis – Positives and contacts to 710, 720, 730 (No 745) HIV – include exposure dates



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call in, then wait on a disposition. Contacts – Call in, then wait on a disposition. Gonorrhea Positive lab results – Call in, then wait on a disposition. Contacts – Call in, then wait on a disposition. Syphilis Positive lab results – Call in, then wait on a disposition. Contacts – Call in, then wait on a disposition. HIV Positive lab results – Call in, then wait on a disposition.. Contacts – Call in, then wait on a disposition.

Michigan (1 of 2) Dept of Health STD Program 109 W Michigan Ave 9th Floor Lansing, MI 48913 Phone number – 517-241-0869 (Sue) 517-241-0868 (Carol) Fax Number - 517-241-0875 Contact name – Sue Leverett (Syphilis, HIV) Carol French (Chlamydia, Gonorrhea) Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – Upon request, mailed, 2 weeks from notification. Gonorrhea – Upon request, mailed, 2 weeks from notification.

Syphilis - 2 weeks from notification, called. HIV – None

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the information, wait on disposition. Contacts – Mail the information, wait on disposition Gonorrhea Positive lab results – Mail the information, wait on disposition Contacts – Mail the information, wait on disposition Syphilis Positive lab results – Call in the information, wait on disposition. Contacts – Call in the information, wait on disposition. HIV Positive lab results – Call in the information, administratively close field record. Contacts – Call in the information, administratively close field record.

Michigan – Detroit (2 of 2) Dept of Health STD Program 8921 John C Lodge Room 206-A Detroit, MI 48202 Phone number – 313-876-0348 – Karen 313-876-0348 - Julia Fax Number Contact name – Karen Lightheart Julia Forney Diseases accepted - Chlamydia – For morbidity only. Gonorrhea – For morbidity only.

Syphilis – Early syphilis for contacts, all stages for positives HIV – None – Contact state office


Syphilis - 2 weeks from notification HIV – Contact state office

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the information, administratively close our field record. Contacts – Gonorrhea Positive lab results – Mail the information, administratively close our field record. Contacts – Syphilis Positive lab results – Mail the information, wait on disposition. Contacts – Mail the information, wait on disposition.. HIV Positive lab results – See page for Michigan - State Contacts – See page for Michigan - State

Minnesota Minnesota Dept of Health STD / HIV Section PO Box 64975 St Paul, MN 55164-0975 Phone number – 651-201-4024 (Cindy) 651-201-4031 (Angie) Fax Number – 651-201-4040 HIV phone number – 651-201-4006 Contact name – Angie Kotrba (CT, GC, Record Search, positive tests) Cindy Lind-Livingston (Syphilis Record Search and positive tests) HIV – Sue Bedard-Johnson Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – 2 weeks from date of notification Gonorrhea - 2 weeks from date of notification


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the field record, then wait for disposition. Contacts – Fax the field record, then wait for disposition. Gonorrhea Positive lab results – Fax the field record, then wait for disposition. Contacts – Fax the field record, then wait for disposition. Syphilis Positive lab results – Fax the field record, then wait for disposition. Contacts – Fax the field record, then wait for disposition. HIV Positive lab results – Fax the field record, then wait for disposition. Contacts – Fax the field record, then wait for disposition.

Mississippi Mississippi Dept of Health Bureau of STD / HIV PO Box 1700 Jackson, MS 39215-1700 Phone number – 601-576-7723 Fax Number – 601-576-7460 HIV phone number - Same Contact name – Vernell Jones Allia Jackson Diseases accepted - Chlamydia (accepted if pt is under 18 or pregnant)

Gonorrhea (accepted if pt is under 18 or pregnant) Syphilis HIV


Syphilis – 30 days from notification HIV – 45 days from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, fax or mail, then wait on disposition. Contacts – Call, fax or mail, then wait on disposition. Gonorrhea Positive lab results – Call, fax or mail, then wait on disposition. Contacts – Call, fax or mail, then wait on disposition. Syphilis Positive lab results – Call, fax or mail, then wait on disposition. Contacts – Call, fax or mail, then wait on disposition. HIV Positive lab results – Call, fax or mail, then wait on disposition. Contacts – Call, fax or mail, then wait on disposition.

Missouri Missouri Dept of Health & Senior Services Bureau of HIV / STD / Hepatitis PO Box 570 Jefferson City, MO 65102-0570 Phone number – 573-751-6142 - Debbie 573-751-6205 – Tricia Fax Number – 573-751-6417 HIV phone number - Same Contact name – Debbie Malone Tricia Sneller Diseases accepted Chlamydia – On four part field record (include all four pages) Gonorrhea – On four part field record (include all four pages)

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification, only when requested. Mailed. Gonorrhea – 2 weeks from notification, only when requested. Mailed.

Syphilis - 2 weeks from notification, only when requested on positives. Partners phoned. HIV - 1 month from the time of notification, only when requested on positives. Partners phoned.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – On four part field record (include all four pages). May also send morb/lab report. Contacts – On four part field record (include all four pages) Gonorrhea Positive lab results – On four part field record (include all four pages) May also send morb/lab report.

Contacts – On four part field record (include all four pages) Syphilis Positive lab results – Call for pregnant females, clients less than 25 years of age, or titer > 1:16. Fax lab report. Contacts – Call, then wait on disposition. HIV Positive lab results – Call, then fax lab report. Contacts – Call, then wait on disposition.

Montana STD Program DPHHS 1400 Broadway Helena, MT 59620-2951 Phone number – 406-444-2457 Fax Number – 406-444-6842 HIV phone number – 406-444-3049 Contact name – Laurie Kops HIV – Jessie Frazier Diseases accepted - Chlamydia – Positives and partners. Gonorrhea – Positives and partners.

Syphilis - Positives and partners. HIV – Positives and partners.

Return of dispositions – Chlamydia – As requested. 2 weeks after notification. Gonorrhea – As requested. 2 weeks after notification.

Syphilis - As requested. 2 weeks after notification. HIV - As requested. 4 weeks after notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call or fax field record and lab, wait on disposition. Contacts – Call or fax field record and lab, wait on disposition. Gonorrhea Positive lab results – Call or fax field record and lab, wait on disposition. Contacts – Call or fax field record and lab, wait on disposition. Syphilis Positive lab results – Call or fax field record and lab, wait on disposition. Contacts – Call or fax field record and lab, wait on disposition. HIV Positive lab results – Call or fax field record and lab, wait on disposition. Contacts – Call or fax field record and lab, wait on disposition.

Nebraska DHHS R & L Communicable Disease – 3rd Floor PO Box 95026 Lincoln, NE 68509-50256 Phone number – 402-471-2937 Fax Number – 402-471-3601 HIV Phone number – 402-471-0360 Contact name – Phil Medina Jane Junken HIV – Tina Brubaker Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – 2 weeks from notification, upon request, called. Gonorrhea – 2 weeks from notification, upon request, called.

Syphilis - 2 weeks from notification, upon request, called. HIV - 4 weeks from notification, upon request.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax or call information, wait on disposition. Contacts – Fax or call information, wait on disposition. Gonorrhea Positive lab results – Fax or call information, wait on disposition. Contacts – Fax or call information, wait on disposition. Syphilis Positive lab results – Fax or call information, wait on disposition. Contacts – Fax or call information, wait on disposition. HIV Positive lab results – Fax or call information, wait on disposition. Contacts – Fax or call information, wait on disposition. .

Nevada Nevada State Health Division Office of Epidemiology 505 E King St Room 204 Carson City, NV 89701-4797 Phone number – 774-684-5919 Fax Number – 774-684-5999 HIV phone number – 775-684-5900 Contact name – Jane Dreiling HIV – Julia Spaulding Diseases accepted Chlamydia – For morbidity only. Gonorrhea – For morbidity only.


Return of dispositions Chlamydia – Carson City and Reno will attempt to locate, Las Vegas does not follow. Gonorrhea – Carson City and Reno will attempt to locate, Las Vegas does not follow.

Syphilis – 2 weeks from notification, via phone or mail. HIV - 4 weeks from notification, via phone or mail.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax information, administratively close our field record. Contacts – Fax information, administratively close our field record. Gonorrhea Positive lab results – Fax information, administratively close our field record. Contacts – Fax f information, administratively close our field record. Syphilis Positive lab results – Fax information, wait on disposition. Contacts – Fax information, wait on disposition. HIV Positive lab results – Fax or call in information, wait on disposition. Contacts – Fax information, wait on disposition.

New Hampshire Dept of Health / Human Services STD / HIV Sectoion 29 Hazen Dr Concord, NJ 03301 Phone number – 603-271-3932 (Heather Barto) 603-271-4490 (Dana Hull) 603-271-3025 (Amy Tozier) Fax Number – 603-271-0545 HIV phone number – 603-271-3932 (Heather Barto) Contact name – Dana Hull – (STD Positives)

HIV - Heather Bartow (Positives) STD / HIV – Amy Tozier (Partners)

Diseases accepted Chlamydia – Positives only. Gonorrhea – Positives only.

Syphilis HIV

Return of dispositions Chlamydia - 2 weeks from notification, upon request, by mail. Gonorrhea - 2 weeks from notification, upon request, by mail.

Syphilis - 2 weeks from notification, upon request, by mail. HIV – 3 to 4 weeks from notification, upon request, by mail.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax information, call for disposition. Contacts – Fax information, call for disposition. Gonorrhea Positive lab results – Fax information, call for disposition. Contacts – Fax information, call for disposition. Syphilis Positive lab results on an OP – Fax information, call for disposition. Contacts – Fax information, call for disposition. HIV Positive lab results on an OP - Call, fax or mail information, close field record. Contacts - Call, fax or mail information, close field record.

New Jersey (1 of 2) NJDHSS / STD 3625 Quakerbridge Rd Trenton, NJ 08625 Phone number – 609-588-7526 Fax Number - 609-588-7462 HIV Phone number – 609-292-7935 Contact name – Steven Dunagan Yanet Barboza HIV - Gale Moore Diseases accepted - Chlamydia – Within CDC year Gonorrhea – Within CDC year

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification Gonorrhea –2 weeks from notification


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail or fax unless patient is a pregnant female, wait on disposition. Contacts - Mail or fax unless patient is a pregnant female, wait on disposition. Gonorrhea Positive lab results - Mail or fax unless patient is a pregnant female, wait on disposition. Contacts – Mail or fax unless patient is a pregnant female, wait on disposition. Syphilis Positive lab results – Call with the lab result, then wait on disposition. Contacts – Call with the lab result, then wait on disposition.. HIV Positive lab results – Call the lab result, then wait on disposition. Contacts – Call the lab results, wait on the disposition.

New Jersey – HIV (2 of 2) NJDHSS - HIV only NJDHSS – Northern Region Office 153 Halsey Street – 7th Fl PO Box 47007 Newark, NJ 07101 HIV - Phone Number: 973-648-7500 HIV - Fax Number: 973-648-7384 Contact name – Stephanie Moore-Hastings, Partner Services (PS) program supervisor or Glenda Simmons, administrative assistant or any PS field representative (aka – NAP rep). Referrals accepted –

HIV+ individual: All HIV+ referrals are accepted regardless of test date. Partner of HIV+ individual: Last exposure date can’t be more than three years from the date the referral is called/mailed.

Return of dispositions –

HIV+ and Partner Referrals – Within 1 month after receiving referral

HOW TO DELIVER TO STATE HIV+ Referral – personal information required: name, address and/or phone number. We prefer that referral also include a physical description (age, race/ethnic, sex, marital status, height, build, hair color, complexion eyes color, and other distinctive characteristics).

HIV+ referral information can be mailed (in envelop marked confidential) or called-in. In either case the referral must include a copy of the test result or the referral will not be assigned for field follow -up. If the referral is called-in the procedure is as follows:

1) Call referral information to NJDHSS Northern Region Office and provide/assign a code number for the referral.

2) Fax test result without personal identifiers with the code number. 3) The coded identifier will be matched to the referral. ** The DHAS-PS program acknowledges the difficulties that some states have in obtaining copies of test results when attempting to refer out-of-state HIV positive clients for purposes as above described. In place of the HIV positive test result the DHAS-PS program will accept a letter signed by someone with the authority to indicate that the referral is that of a confirmed HIV positive individual. This letter must be written on letterhead (state Department of Health or agency responsible for referral). Again, must use a coded number in lieu of identifiers. The letter may be faxed to (973) 648-7384. The coded identifier will be matched to the referral.

Partner Referral - personal information required: name, address and/or phone number. We prefer that referral also include a physical description (age, race/ethnic, sex, marital status, height, build, hair color, complexion eyes color, and other distinctive characteristics), first and last exposure, type(s) of exposure and sexual preference. HIV+ referral information can be mailed (in envelop marked confidential) or called in.

New Mexico New Mexico Dept of Health STD Program 1190 St Francis Dr PO Box 26110 Santa Fe, NM 87502-6110 Phone number – 505-576-3636 Fax Number – 505-476-3638 HIV phone number – 505-476-3515 Contact name – Lewis Smith Sarah Valway HIV – Lily Foster Diseases accepted - Chlamydia – For morbidity only. Gonorrhea – For morbidity only, unless pregnant.


Return of dispositions – Chlamydia – Pregnant females only. Mailed, but can fax. 2 weeks from notification. Gonorrhea – Partners and pregnant females only. Mailed, but can fax. 2 weeks from notification.

Syphilis – 2 weeks from notification, via mail or fax. HIV - 4 weeks from notification, via mail or fax.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax field record and lab, administratively close our field record, unless pregnant. Contacts – Fax field record and lab, administratively close our field record. Gonorrhea Positive lab results – Fax field record and lab, administratively close our field record, unless pregnant. Contacts – Fax field record and lab, wait on disposition Syphilis Positive lab results – Fax field record and lab, wait on disposition. Contacts – Fax field record and lab, wait on disposition. HIV Positive lab results – Fax field record and lab, wait on disposition. Contacts – Fax field record and lab, wait on disposition.

New York (1 of 2) New York Dept of Health Bureau STD Control ESP Corning Tower Room 1168 Albany, NY 12237 Phone number – 518-474-8181 Fax Number - 518-474-3491 HIV Phone number – Same unless client lives in New York City Contact name – Suzanne Whitford Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – Gonorrhea –


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Contacts – Gonorrhea Positive lab results – Contacts – Syphilis Positive lab results – Call or mail field record with the lab result, then wait on disposition. Contact – Call or mail field record with the lab result, then wait on disposition. HIV Positive lab results – Call the lab result, then wait on disposition. Contacts – Call the lab results, wait on the disposition.

New York City (2 of 2) Dept of Health STD Program PO Box 60630 2nd Floor New York, NY 70160 Phone number – 212-788-4465 Fax Number HIV Phone number – 212-788-4444 or 212-788-4443 Contact name – Kathy Carter Robin Houston Diseases accepted - Chlamydia – Male contacts < 2 months from specimen date, female contacts < 4 months, all positive test results Gonorrhea – Male contacts < 2 months from specimen date, female contacts < 4 months, all positive test results

Syphilis HIV

Return of dispositions – Chlamydia – Gonorrhea –


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Contacts – Gonorrhea Positive lab results – Contacts – Syphilis Positive lab results – Call with the lab result, then wait on disposition. Contacts – Call with the lab result, then wait on disposition.. HIV Positive lab results – Call the lab result, then wait on disposition. Contacts – Call the lab results, wait on the disposition.

North Carolina Linda Smith NCDHHS/CD Branch/HIV-STD Black Mountain Regional Office 952 Old US Hwy 70 Black Mountain, NC 28711 Phone number – 828-669-3350 Fax Number HIV – Contact name – Linda Smith HIV - Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail field record and labs and administratively close record. Contacts – Mail field record and labs and administratively close record. Gonorrhea Positive lab results – Mail field record and labs and administratively close record. Contacts – Mail field record and labs and administratively close record. Syphilis Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition. HIV Positive lab results – Call in information, wait on disposition. Contacts – Call in information, wait on disposition.

North Dakota North Dakota Dept of Health Division of Disease Control 600 E Boulevard Ave Bismarck, ND 58505-0118 Phone number – 701-328-2378 Fax Number – 701-328-2499 HIV Phone number – Same Contact name – Julie Goplin HIV – Rachel Birk Diseases accepted Chlamydia – For morbidity only. Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – None. Gonorrhea – 2 weeks from notification or on completion of investigation. By mail.

Syphilis– 2 weeks from notification or on completion of investigation. By phone. HIV - 1 month from the time of notification. By phone or mail.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail information, administratively close field record. Contacts – Mail information, administratively close field record. Gonorrhea Positive lab results – Mail information, wait on disposition. Contacts – Mail information, wait on disposition. Syphilis Positive lab results – Call in information, wait on disposition. Contacts - Call in information, wait on disposition HIV Positive lab results - Call in information, wait on disposition Contacts - Call in information, wait on disposition

Ohio Ohio Department of Health / HIV/STD Prevention Program P. O. Box 118 Columbus, OH 43216-0118 Phone number – 614-466-2446 Fax Number – 614-387-2602 HIV & Syphilis Contacts Contact name – Carol Brock Diseases accepted - Chlamydia – Pregnant females only Gonorrhea – Pregnant females only

Syphilis - HIV -



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax the field record, administratively close the field record. Contact - Fax the field record, administratively close the field record. Gonorrhea Positive lab results - Fax the field record, administratively close the field record. Contacts - Fax the field record, administratively close the field record. Syphilis Positive lab results – Call Carol in Ohio or fax the field record, then wait on disposition. Contacts – Call Carol in Ohio or fax the field record, then wait on disposition. HIV Positive lab results – Call Carol in Ohio or fax the field record, then wait on disposition. Contacts – Call Carol in Ohio or fax the field record, wait on the disposition.

Oklahoma Oklahoma State Dept of Health Maildrop-0308 Oklahoma City, OK 43117 Phone number – 405-271-7444 X 56636 (Cynthia) Fax Number – HIV phone number – 405-271-9444 X 56631 (Olivia) Contact name – Cynthia McNack Olivia Scott Diseases accepted - Chlamydia – Pregnant females or partners to pregnant females. Chlamydia – Pregnant females or partners to pregnant females.

Syphilis – 710, 720, 730 HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call with the information, then administratively close our field record. Contact - Call with the information, then administratively close our field record. Gonorrhea Positive lab results - Call with the information, then administratively close our field record. Contacts - Call with the information, then administratively close our field record. Syphilis Positive lab results – Call with the information, then wait on disposition. Contacts – Call with the information, then wait on disposition. HIV Positive lab results – Call with the information, then wait on disposition. Contacts – Call with the information, then wait on disposition.

Oregon Oregon Health Services HIV / STD Program Ste # 1105 800 NE Oregon St Portland, OR 97232 Phone number – 971-673-0152 (Gary) 971-673-0172 (Steve) Fax Number – 971-673-0178 HIV phone number – Same Contact name – Gary Fosnaugh Steve Foye Diseases accepted Chlamydia Gonorrhea

Syphilis – When exposure dates are less than 6 months. HIV

Return of dispositions Chlamydia – 2 weeks after notification, mailed. Gonorrhea – 2 weeks after notification, mailed.

Syphilis - 2 weeks from notification, faxed HIV - 1 month from the time of notification, faxed.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call or fax the information, wait on disposition. Contact - Call or fax the information, wait on disposition. Gonorrhea Positive lab results - Call or fax the information, wait on disposition. Contacts - Call or fax the information, wait on disposition. Syphilis Positive lab results – Call with the information, then wait on disposition. Contacts – Call with the information, then wait on disposition. HIV Positive lab results – Call with the information, then wait on disposition. Contacts – Call with the information, then wait on disposition.

Pennsylvania (1 of 2) Communicable Diseases - STD Room 1013 Health and Welfare Bldg 7th and Forster Streets Harrisburg, PA 17120 Phone number – 717-787-3981 Fax Number – 717-772-4309 HIV phone number – 717-783-0572 Contact name – Shannon Downing HIV – Robert Burton Diseases accepted - Chlamydia – Pregnant and children under 15 only. Chlamydia – Pregnant and children under 15 only.

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax, then call for disposition. Contacts – Fax, then call for disposition. Gonorrhea Positive lab results – Fax, then call for disposition. Contacts – Fax, then call for disposition. Syphilis Positive lab results on an OP – Call in or fax, call for disposition. Contacts – Call in or fax, call for disposition. HIV Positive lab results on an OP – Contacts -

Pennsylvania – City of Philadelphia (2 of 2) Philadelphia Dept of Health Division of Disease Control – STD Program 500 S Broad St Philadelphia, PA 19146 Phone number – 215-685-6464 (Alex Phillips) 215-685-6453 (Simone Morgan) 215-685-6585 (Jackie Miller) Surveillance Fax Number – 215-685-6798 Field Fax Number 215.685.6509 HIV phone number – 215-685-4792 Contact name – Alex Miller (Chlamydia, Gonorrhea) Simone Morgan (Chlamydia, Gonorrhea) Jackie Miller (Syphilis) Diseases accepted Chlamydia – Positives only. Chlamydia – Positives only.

Syphilis HIV - Commonwealth of Pennsylvania 1.717.787.3981

Return of dispositions Chlamydia - 2 weeks from notification, upon request. Gonorrhea - 2 weeks from notification, upon request.

Syphilis - 2 weeks from notification, upon request. HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax, then call for disposition. Contacts – Fax, then call for disposition. Gonorrhea Positive lab results – Fax, then call for disposition. Contacts – Fax, then call for disposition. Syphilis Positive lab results on an OP – Call in or fax, call for disposition. Contacts – Call in or fax, call for disposition. HIV Positive lab results on an OP Contacts

Rhode Island Rhode Island Dept of Health Division of Disease Control and Prevention STD Program Three Capitol Hill Room 106 Providence, RI 02908 Phone number – 401 222-7542 Fax Number – HIV phone number – 401-639-6315 Contact name – Carol Browning HIV - Diseases accepted - Chlamydia – less than 2 months from the date of specimen Gonorrhea – less than 2 months from the date of specimen

Syphilis – Primary and Secondary only HIV

Return of dispositions – Chlamydia – May or may not return a disposition – 2 weeks if they do. Gonorrhea – May or may not return a disposition – 2 weeks if they do.


HOW TO DELIVER TO STATE Chlamydia Positive lab results – New cases – phoned in, others faxed. Wait on disposition. Contacts – New cases – phoned in, others faxed. Wait on disposition. Gonorrhea Positive lab results – New cases – phoned in, others faxed. Wait on disposition. Contacts – New cases – phoned in, others faxed. Wait on disposition. Syphilis Positive lab results – New cases – phoned in, others faxed. Wait on disposition. Contacts – New cases – phoned in, others faxed. Wait on disposition. HIV Positive lab results – Call in the lab results, wait on the disposition Contacts – Call in the lab results, wait on the disposition.

South Carolina SCDHEC Mills / Jarrett Bldg 1751 Calhoun St Columbia, SC 29211 Phone number – 803-898-0630 (CT and GC) 803-898-0864 (Syphilis) Fax Number HIV Phone number – 803-898-0797 Contact name – Karen Anderson – CT, GC and syphilis record searches Bobbie Rinehart – Syphilis contacts Lenora Torres – HIV Mereena Coyac - HIV Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks for notification Gonorrhea– 2 weeks for notification


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail in and then wait on disposition. Contacts – Mail in and then wait on disposition. Gonorrhea Positive lab results – Call in and then wait on disposition. Contacts – Call in and then wait on disposition. Syphilis Positive lab results – Call with the lab result, then wait on disposition. Contact – Call with the lab result, then wait on disposition.. HIV Positive lab results – Call the lab result, then wait on disposition. Contacts – Call the lab results, wait on the disposition.

South Dakota South Dakota Dept of Health 615 E 4th St Pierre, SD 57501 Phone number – 605-773-4794 Fax Number – 605-773-5509 HIV Phone number – 605-773-3523 Contact name – Dave Morgan HIV – Christine Olsen Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – 2 weeks after notification, by mail. Gonorrhea – 2 weeks after notification, by mail.

Syphilis - 2 weeks after notification, by mail. HIV - 1 month after notification, by mail.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail or fax information, wait on disposition. Contacts – Mail or fax information, wait on disposition. Gonorrhea Positive lab results – Mail or fax information, wait on disposition. Contacts – Mail or fax information, wait on disposition. Syphilis Positive lab results - Mail or fax information, wait on disposition. Contacts - Mail or fax information, wait on disposition. HIV Positive lab results - Mail or fax information, wait on disposition. Contacts - Mail or fax information, wait on disposition.

Tennessee Tennessee Dept of Health Cordell Hull Bldg 425 5th Ave North Nashville, TN 37247 Phone number – 615-532-8488 Fax Number – 615-253-1686 Contact name – Michael Mosley HIV – Joe Holmes Diseases accepted - Chlamydia Gonorrhea

Syphilis – Less than one year, unless married. HIV – Less than one year, unless married.

Return of dispositions – Chlamydia - None Gonorrhea - None

Syphilis - 2 weeks from notification – will call. HIV - 1 month from the time of notification – will call.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab result, administratively close field record. Contact – Mail the lab result, administratively close field record. Gonorrhea Positive lab results – Mail the lab result, administratively close field record. Contact – Mail the lab result, administratively close field record. Syphilis Positive lab results – Fax the information, then wait on disposition. Contacts – Fax the information, then wait on disposition. HIV Positive lab results – Fax information, then wait on disposition. Contacts– Fax the information, then wait on disposition.

Texas - Dallas (1 of 3) Texas Dept of Health HIV / STD Surveillance Branch 2377 N Stemmons Ste 132 Dallas, TX 75207 Phone number – 214-819-2135 Fax Number – 214-819-2825 HIV Phone number Contact name – Alishea Helm Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax or mail field record, wait on disposition. Contacts – Fax or mail field record, wait on disposition. Gonorrhea Positive lab results – Fax or mail field record, wait on disposition. Contacts – Fax or mail field record, wait on disposition. Syphilis Positive lab results – Fax field record, wait on disposition. Contacts – Fax field record, wait on disposition. HIV Positive lab results – Call and then fax field record, wait on disposition. Contacts – Call and then fax field record, wait on disposition.

Texas - Austin (2 of 3) Texas Dept of Health HIV / STD Surveillance Branch 1100 W 49th St Austin, TX 78756 Phone number – 512-533-3029 (Minerva) 512-533-3032 (Richard) Fax Number – 512-371-4674 (please notify Minerva or Richard of fax) HIV Phone number – 512-533-3037 Contact name – Minerva Gomez Richard Armor Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax or mail field record, call for disposition. Contacts – Fax or mail field record, call for disposition. Gonorrhea Positive lab results – Fax or mail field record, call for disposition. Contacts – Fax or mail field record, call for disposition. Syphilis Positive lab results – Fax field record, wait on disposition. Contacts – Fax field record, wait on disposition. HIV Positive lab results – Fax field record, wait on disposition. Contacts – Fax field record, wait on disposition.

Texas - Houston (3 of 3) Houston Health and Human Services ATTN : Katina Lane 8000 N Stadium Dr 4th Floor Houston, TX 77054 Phone number – 713-794-9254 Fax Number – 713-798-0825 HIV Phone number Contact name – Katina Lane Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks for notification for partners / clusters. On request for positives. Gonorrhea – 2 weeks for notification for partners / clusters. On request for positives


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call and then fax or mail field record, wait on disposition. Contacts – Call and then fax or mail field record, wait on disposition. Gonorrhea Positive lab results – Call and then fax or mail field record, wait on disposition. Contacts – Call and then fax or mail field record, wait on disposition. Syphilis Positive lab results – Call and then fax or mail field record, wait on disposition. Contacts – Call and then fax or mail field record, wait on disposition. HIV Positive lab results – Call and then fax or mail field record, wait on disposition. Contacts – Call and then fax field record, wait on disposition.

Utah Utah Department of Health HIV/STD/HepC Prevention Program Bureau of Communicable Disease Control PO Box 142105 Salt Lake City, UT 84114 Bureau Main number – 801-538-6096 Bureau Fax Number – 801-538-9913 STD Surveillance contact (Chlamydia, Gonorrhea, Syphilis only) – Angie Martinez, 801-538-6171 HIV Surveillance contact (HIV/AIDS only) – Leslie Clark, 801-538-6116 Diseases accepted Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions Chlamydia – 2 weeks from notification, upon request, called. Gonorrhea – 2 weeks from notification, upon request, called.

Syphilis - 2 weeks from notification, upon request, called. HIV - None

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, fax or mail field record, administratively close field record. Contacts – Call, fax or mail field record, administratively close field record. Gonorrhea Positive lab results – Call, fax or mail field record, administratively close field record. Contacts – Call, fax or mail field record, administratively close field record. Syphilis Positive lab results – Call or fax field record, administratively close field record. Contacts – Call or fax field record, administratively close field record. HIV Positive lab results – Call or fax field record, administratively close field record. Contacts – Call or fax field record, administratively close field record.

Vermont STD Program VDH PO Box 70 Room 305 Burlington, VT 05402 Phone number – 802-863-730 Fax Number – 804-863-7314 HIV phone number – 802-863-7572 Contact name – Daniel Daltry HIV – Mathew Pettengill Diseases accepted - Chlamydia Gonorrhea

Syphilis – 710, 720, 730 positives and partners HIV – Positives only

Return of dispositions – Chlamydia – 2 weeks from notification for contacts, by phone. Gonorrhea – 2 weeks from notification for contacts, by phone. Syphilis - 2 weeks from notification for contacts, by phone..

HIV - None HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call with information, wait on disposition. Contacts – Call with information, wait on disposition. Gonorrhea Positive lab results – Call with information, wait on disposition. Contacts – Call with information, wait on disposition. Syphilis Positive lab results – Call with information, wait on disposition. Contacts – Call with information, wait on disposition. HIV Positive lab results – Mail information, administratively close field record. Contacts – Not applicable.

Virginia Virginia Dept of Health 109 Governors St 2nd Floor Richmond, VA 23219 Phone number – 804-864-8001 (Andrew) 804-864-7994 (Kevin) Fax Number – 804-864-8052 HIV phone number – 804-864-8037 804-864-7999 – Sue Willis 804-864-8032 – Sharon Carter Contact name – Andrew Johnson Kevin Jones HIV - Lynn Curry – Contacts to 900 Sue Willis – HIV positives Sharon Carter – HIV positives Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification for contacts. Gonorrhea – 2 weeks from notification for contacts.


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab results, wait on disposition Contacts – Mail the lab results, wait on disposition Gonorrhea Positive lab results – Mail the lab results, wait on disposition Contacts – Mail the lab results, wait on disposition Syphilis Positive lab results – Call in the lab results, wait on the disposition Contacts – Call in the lab results, wait on the disposition. HIV Positive lab results – Call in the lab results, wait on the disposition Contacts – Call in the lab results, wait on the disposition.

Washington State of Washington STD Services PO Box 47842 Olympia, WA 98504-7842 Phone number – 360-236-3433 Fax Number – 360-236-3470 HIV phone number – 360-236-3409 Contact name – Rayna Halloway HIV - Tom Jaenicke Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax or phone, administratively close field record. Contacts – Fax or phone, administratively close field record. Gonorrhea Positive lab results – Fax or phone, administratively close field record. Contacts – Fax or phone, administratively close field record. Syphilis Positive lab results – Fax or phone, call back for disposition. Contacts – Fax or phone, call back for disposition. HIV Positive lab results – Fax or phone, call back for disposition. Contacts – Fax or phone, call back for disposition. .

Washington DC Washington DC Dept of Health Division of STD Control 717 14th St NW Ste 950 MB # 14 Washington DC 20005 Phone number – 202-442-4776 Fax Number 202-727-4934 HIV – 202-727-6408 Contact name – Jennifer Johnson HIV - Michelle Harried Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, fax or mail. Call back for disposition Contacts– Call, fax or mail. Call back for disposition Gonorrhea Positive lab results – Call, fax or mail. Call back for disposition Contacts – Call, fax or mail. Call back for disposition Syphilis Positive lab results – Call, fax or mail. Call back for disposition. Contacts – Call, fax or mail. Call back for disposition HIV Positive lab results– Call, fax or mail. Call back for disposition. Contacts – Call, fax or mail. Call back for disposition

West Virginia West Virginia Dept of Health Floor Richmond, WV Phone number – 304-558-6434 Fax Number HIV phone number Contact name – Barbie Thacker Diseases accepted - Chlamydia – Less than 3 months from date of specimen, without treatment. Gonorrhea – Less than 3 months from date of specimen, without treatment.

Syphilis HIV

Return of dispositions – Chlamydia – 2 weeks from notification for contacts. Gonorrhea – 2 weeks from notification for contacts.


HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail the lab results, wait on disposition Contacts – Mail the lab results, wait on disposition Gonorrhea Positive lab results – Mail the lab results, wait on disposition Contacts – Mail the lab results, wait on disposition Syphilis Positive lab results – Call in the lab results, wait on the disposition Contacts – Call in the lab results, wait on the disposition. HIV Positive lab results – Call in the lab results, wait on the disposition Contacts – Call in the lab results, wait on the disposition.

Wisconsin – (1 of 2) Wisconsin Dept of Health 1 W Wilson St Rm 318 Madison, WI 53701-2659 STD Phone number – 608-266-7365 STD Fax Number – 608-261-9301 HIV Phone number – 608-267-5288 608-266-2906 (Surveillance) HIV Fax Number - 608-266-1288 Contact name

STD– Karen Dixon HIV – Dhana Shrestha

Diseases accepted Chlamydia – For morbidity only. Gonorrhea - For morbidity only.

Syphilis HIV

Return of dispositions Chlamydia – None. Gonorrhea – None.

Syphilis - 2 weeks from notification or on completion of investigation. Called and faxed. HIV - 1 month from the time of notification.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Mail information, administratively close field record. Contacts – Mail information, administratively close field record. Gonorrhea Positive lab results – Mail information, administratively close field record. Contacts – Mail information, administratively close field record. Syphilis Positive lab results – Call then fax information, wait on disposition. Contacts – Call then fax information, wait on disposition. HIV Positive lab results – Call then fax information to Dhana, wait on disposition. Contacts – Call then fax information to surveillance, wait on disposition.

Wisconsin – Milwaukee (1 of 2) Keenan Central Health Clinic 3200 N 36th St Milwaukee, WI 53216 Phone number – 414-286-8058 Fax Number – 414-286-8173 HIV Phone number Contact name – Vanessa Vann Lisa Fixx - HIV Diseases accepted - Chlamydia – Untreated cases, pregnant women, patients under 16 years of age. Gonorrhea - Untreated cases, pregnant women, patients under 16 years of age.

Syphilis HIV



HOW TO DELIVER TO STATE Chlamydia Positive lab results – Call, fax or mail. Contacts – Call, fax or mail. Gonorrhea Positive lab results – Call, fax or mail. Contacts – Call, fax or mail. Syphilis Positive lab results – Call, fax or mail, wait on disposition. Contacts – Call, fax or mail, wait on disposition. HIV Positive lab results – Call, fax or mail, wait on disposition. Contacts – Call, fax or mail, wait on disposition.

Wyoming Wyoming Dept of Health, Communicable Disease Section STD / Infertility Program 6101 Yellowstone Rd # 510 Cheyenne, WY 82002 Phone number – 307-777-7953 Fax Number – 307-777-5279 HIV Phone number - 307-777-7719 Fax number – 307-777-6144 Contact name – Julie Tarbuck HIV – Cheryl Corbin Diseases accepted - Chlamydia Gonorrhea

Syphilis HIV

Return of dispositions – Chlamydia – Upon request. Gonorrhea – Upon request.

Syphilis - Upon request. HIV - Upon request.

HOW TO DELIVER TO STATE Chlamydia Positive lab results – Fax information, call back for disposition, if requested. Contacts – Fax information, call back for disposition, if requested. Gonorrhea Positive lab results – Fax information, call back for disposition, if requested. Contacts – Fax information, call back for disposition, if requested. Syphilis Positive lab results – Fax information, call back for disposition, if requested. Contacts – Fax information, call back for disposition, if requested. HIV Positive lab results – Fax information, call back for disposition, if requested. Contacts – Fax information, call back for disposition, if requested.

Interstate Communication Control Record (ICCR) · 2008. 10. 27. · Interstate Communication ....

Documents

Transcript of Interstate Communication Control Record (ICCR) · 2008. 10. 27. · Interstate Communication ....