Direct Data Entry for Notifiable Conditions

Organization Information

If you have questions, please email KHIElabs@ky.gov.

Please provide the following details using corporate ownership information. You will have the opportunity, below in the next section, to list the names of each location included under this ownership. Please complete just one form per corporate organization.

* Organization Legal Name

Organization Name

(If different from above)

* Organization Phone Number

* Address Line 1

Address Line 2

* City

* State

* Zip Code

County

Required for Kentucky Organizations Only

Organization Primary Contact Information

* Full Name

* Phone Number

* Email Address

Organization Infection Interventionist Contact Information

* Full Name

* Phone Number

* Email Address

Which Direct Data Entry (DDE) service(s) are you interested in?

Electronic Case Reporting

Replaces faxing EPID forms

Expanded Lab Reporting

Enter lab results for MDRO’s, STD’s, Hepatitis, and other reportable conditions under 902 KAR 2:02

Electronic COVID-19 Lab Reporting only