Hamilton County Public Health

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Use this form to report a POSTIVE COVID-19 test result from a HOME TEST KIT ONLY!
Please note this form is for HAMILTON COUNY RESIDENTS ONLY!
Upon completion, you will receive an acknowledgement on the screen as well as an email.

Email *

Today's Date: *

YYYY

First Name: (Who tested POSTIVE) *

Last Name: *

Date of Birth: *

YYYY

Telephone Number: *

Street Address: *

Town, Zip Code, County *

Date of Symptoms Began: *

YYYY

Date of Positive At Home Test: *

YYYY

A copy of your responses will be emailed to the address you provided.

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