Form

Hepatitis: form for reporting cases from GUM to HPTs

Forms for reporting cases of acute hepatitis A, acute hepatitis B and acute hepatitis C diagnosed in Genitourinary Medicine Clinics (GUM) to local health protection teams (HPTs).

• From: Public Health England
• Published: 1 December 2009
• Last updated: 21 October 2015 — See all updates

Documents

Form for reporting hepatitis from GUM to HPTs (MS Word)

MS Word Document, 142 KB

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Form for reporting Hepatitis from GUM to HPTs (PDF)

PDF, 204 KB, 1 page

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Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

These forms were developed by PHE hepatitis leads and the British Association of Sexual Health and HIV (BASHH). Please complete and return either form via secure fax or post to your local health protection team.

Published 1 December 2009
Last updated 21 October 2015 + show all updates

1. 21 October 2015

   Updated form for GUMs to report acute HAV, HBV and HCV cases to their local HPT.

2. 1 December 2009

   First published.