Data and Presentation Request Form: STD/HIV/TB Section

Please note: Requests may not be completed by requested due date if surveillance staff are given less than 2 weeks to complete the analyses.

Staff will be in touch with you to negotiate/confirm a final date for product delivery or presentation and to clarify any questions.

For data or presentations regarding diseases other than STDs or TB, see: Diseases and Conditions Statistics.
(Required fields are indicated with *)

Contact Information

Disease topic(s) for data or presentation requested. (Choose all that apply.)*

Type of request (presentation, data, other)*


Intended use: (Choose all that apply.)


Character limit: 1500.