COVID Reporting Portal Registration Form (Not for At-Home Test Reporting)
If you are an individual trying to report an at-home COVID test, do NOT fill out this form. You can report your test through this website: https://covidbinax.colorado.gov/login. You will need to create an account first. For facility name - enter "home. For facility address - enter your home address.

The Disease Control and Public Health Response portal is used by providers, hospitals or laboratories that are needing to report COVID-19 tests performed at their facility. Please submit one form for each person needing access at your facility.




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1. I would like to register to report COVID cases using the CDPHE web-based COVID reporting portal and understand this is for reporting point-of-care tests only:
2. Full name of person completing this form: *
3. Phone number of person completing this form: *
4. Email of person completing this form: *
5. Type of facility (clinic, hospital, local public health agency, long term care facility etc.)
6. Facility Name: *
7. Facility Address (street, city, state, zip): *
8. What county is your facility located in?
9. Number of locations associated with this facility:
10. If multiple locations, please list the facility name and address for each location below:
11. Does your facility send specimens to a laboratory for COVID testing?
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12. Which lab/s does your facility send specimens to for COVID testing?
13. How does your facility currently report COVID test results for specimens sent to a lab?
14. Does your facility run in-house point-of-care COVID tests?
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15. Which COVID point-of-care test/s is your facility currently using? (Please include test brand, test type, and specimen type) *
16. Have COVID results already been reported to public health?
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17. If yes, who have they been reported to and what method was used?
18. What file types can you generate? (select all that apply) *
19. Do you have any comments/questions related to the COVID reporting?
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