1. Introduction to the Electronic Adult HIV/AIDS Case Report Form Georgia Department of Public Health HIV/AIDS Surveillance Program

2. Introduction
The Georgia Department of Public Health has developed the Electronic Adult Case Report Form (eACRF).
This form is supported by State Electronic Notifiable Disease Surveillance System (SendSS).
This form does not replaces the current avenues that are available for reporting HIV/AIDS.
This presentation will provide generalized steps for accessing and submitting the eACRF.

3. HIV Reporting Differs From Notifiable Disease Reporting
Reporting HIV/AIDS in SENDSS is a different process and has features to protect PII. It is only meant to replace having to mail forms to HIV Surveillance.
Please Note…
You cannot search patients in the HIV Case Reporting Module as you can in other disease reporting modules.
You cannot retrieve case reports that you have previously submitted. 
A 15 minute time out clock starts after entering your first data point on the form. If you don’t finalize your form before the clock times out your data will be lost and nothing submitted.
Please print out your HIV case reports to retain a record of what you have reported.

4. Register or Login to SendSS
To access the eACRF the reporter will have to login to SendSS .
If you do not have a login, you will have to register.
SendSS can be accessed at:
Registration Form for New Account
Login
How to Use SendSS Training
How to Register on SendSS Training

5. Agree with Disclaimer To move Forward

6. Navigate to the eACRF
Case Reporting Tab
HIV/AIDS Case Report

7. Please notice there are a few required items you must have to submit a complete report. Without these the form will not save and submit.
Once you verify you have those items, please click “Yes” here.

8. Please do your best to complete every section of the form.
The only variables that are required to successfully submit the eACRF are the variables with the RED dot beside them.

9. Facility Lookup Facility Completing the Form, Facility at HIV Diagnosis, Facility at AIDS Diagnosis
Click this link
This popup will take you to the look up table

10. Facility Lookup Continued.
Type in a facility key word
Select the facility with the right address

11. Facility Lookup Continued.
Click here if same as facility completing the form
Hand enter if not on facility table

12. Residence at HIV and/or AIDS Diagnosis
Physician
Residence at HIV and/or AIDS Diagnosis

13. Patient Risk History

14. HIV Test Results
Select this only option also for GEENIUS test. (Any Type Differentiating AB test)
Please check all drop down menus for test names. They are organized by:
Antibody -Type Differentiating and Non-Type Differentiating
Antigen – Qualitative and Quantitative
Immunologic Test – CD4 only. No CD3 or CD8 needed

15. HIV Test Results continued

16. STD Co-Infections

17. AIDS Defining Opportunistic Infections

18. Medical Treatment and Pregnancy Hx

19. HIV Testing and ART Hx

20. Comments & Save
Please enter any extra tests or important additional information in the Comments box.
Once all the information is entered in the form click the “Save” button

21. Error Check Box
If any mistakes are made this box will be appear.

22. Review Form You will be given the chance to review the form.
If you see any mistakes, click “Edit” to return to the document.
If all is correct, click “Print Version” to print a version of your form or click “Finalize”.

23. Once you click “Finalize”, the system will tell you that this is your last opportunity to review the form before it is submitted
Press “Edit” if you see a mistake.
Print a copy for your records.
Click “Finalize” now to complete submission .

24. Enter Another Form or Exit
Once you completed the eACRF and successfully submitted it, this box will appear
Click “Continue” to enter another eACRF.
Click “Exit” to exit the HIV Reporting Module.

25. Georgia HIV Surveillance Section
QUESTIONS?
Georgia HIV Surveillance Section
No Faxing Permitted Georgia Department of Public Health, Epi Section P.O. Box 2107
Main Web Page:
Please check in periodically for annually updated paper ACRF forms, Research, HIV Fact Sheets and Surveillance Summaries