Report of Exposure to HIV and other Infectious Diseases (IDPH 406)
Form for reporting occupational exposure to HIV and/or other infectious diseases as defined by Iowa Code 139A.2. A care provider (e.g., health care provider, basic or advanced emergency medical care provider, peace officer, firefighter, or individual rendering emergency care) who has sustained an exposure to potentially infectious body fluids should file this report with the infection control or occupational health office of the hospital or office/clinic in which the exposure occurred, or with the hospital/clinic/office to which the patient was transported, when the exposure occurred elsewhere.