ILINet Sentinel Provider Enrollment Form

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2023-2024 Influenza Season

West Virginia Department of Health and Human Resources

Division of Infectious Disease Epidemiology

Please enter the required information and press "submit". You will receive a confirmation email with more information once your enrollment has been processed.

*Providers currently reporting for the 2022-2023 season, please share your intent for continued participation in ILINet for the 2023-2024 season. If you do not confirm your interest in participation, your account will be disabled on October 4, 2023.

Please feel free to reach out to me with any questions.

Jillian.L.Wall@wv.gov

(304) 352-6217

Practice Name *

Did you participate in ILINet influenza surveillance during the 2022-2023 season or any past season? *

Yes

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