Forms for Reporting a Preliminary Positive Rapid HIV Test
When you encounter a patient with a preliminary positive rapid HIV test, there are 2 forms to complete.
1) The first is the Preliminary Positive Release of Information Form which authorizes case management involvement to assist linking a patient to care.
2) The second is the Preliminary Positive Case Reporting Form which documents the preliminary positive rapid HIV test and is required by the state of Illinois.
Preliminary Positive Release of Information Form
The first form required when you encounter a preliminarily HIV-positive patient. When signed by a patient, this form authorizes a health care provider to disclose a patient's preliminary HIV status and contact information to the Pediatric AIDS Chicago Prevention Initiative for the purpose of providing case management follow-up.
Preliminary Positive Case Reporting Form
The second form required when you encounter a preliminarily HIV-positive patient. To be completed by Illinois hospital staff for every preliminary positve rapid HIV test result and faxed to the Pediatric AIDS Chicago Prevention Initiative. This form is required by the state of Illinois.
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